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You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease II1 Apr 2010

650 PREDICTING ERECTILE DYSFUNCTION FOLLOWING SURGICAL CORRECTION OF PEYRONIE'S DISEASE WITHOUT INFLATABLE PENILE PROSTHESIS PLACEMENT: VASCULAR ASSESSMENT AND PREOPERATIVE RISK FACTORS

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    INTRODUCTION AND OBJECTIVES

    Surgical therapy remains the gold standard treatment for Peyronie's Disease (PD). Surgical options include plication, grafting, and placement of inflatable penile prosthesis (IPP). Postoperative erectile dysfunction (ED) is a potential complication for corrective PD surgery without IPP. We present our large series follow up to evaluate preoperative risk factors for the development of postoperative ED.

    METHODS

    We identified 218 men undergoing either tunica albuginea plication (TAP) or partial plaque excision with pericardial grafting (PEG) for PD between November 1992 and April 2007. Objective data was collected including preoperative and postoperative erectile function, curvature characteristics,graft size, and the presence of vascular risk factors such as hypertension, diabetes mellitus, and smoking history on 142 patients. In addition, preoperative duplex ultrasound findings on 109 of these 142 patients were analyzed with respect to resistive index, peak systolic velocity, and end diastolic velocity. Statistical analysis was performed using R (University of Vienna).

    RESULTS

    10% of TAP and 21% of PEG patients developed postoperative ED. Neither curve direction (p=0.76), graft area (p=0.78), surgical approach (p= 0.12), chronic hypertension (p=0.51), hyperlipidemia (p=0.87), diabetes (p=0.69) nor smoking history (p=0.99) were significant predictors of postoperative ED. Likewise, no combination of risk factors was found to be predictive of postoperative ED. Preoperative use of PDE5-i was not a significant predictor of postoperative ED (p=0.33). Neither peak systolic, end diastolic, nor resistive index were significant predictors of ED (p= 0.28, 0.28, and 0.25 respectively).

    CONCLUSIONS

    This long term follow up of a large published series suggests that neither preoperative risk factors nor preoperative duplex ultrasound findings are predictive of postoperative ED and failed to improve upon previously published preoperative treatment algorithms.

    Chicago, IL

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