Salvage Penile Curvature Correction Surgery
Resource
JOURNAL OF ANDROLOGY v.31 n.5 pp.450-456
Journal
Journal of Andrology
Pages
450-456
Date Issued
2010
Date
2010
Author(s)
HSIEH, CHENG-HSING
CHEN, HENG-SHUEN
LEE, WEN-YUAN
CHEN, KUO-LIANG
CHANG, CHAO-HSIANG
HSU, GENG- LONG
Abstract
It is commonly believed that coarser suture materials should be used to provide sufficient tenacity in surgery for penile curvature correction. We report our 15-year experience of fine sutures in a second operation in 31 patients who underwent prior curvature correction elsewhere with coarser sutures, resulting in recurrent penile curvature. Suture materials used in prior surgeries in these patients were either 2-0 or 3-0 nylon sutures. In this series, all 31 patients underwent a modified Nesbit procedure at the level of the collagen bundles using finer sutures. Prior to July 1998, 10 men underwent salvage surgery using 4-0 polyglactin sutures. Thereafter, we adapted 6-0 nylon sutures for another 21 patients. We categorized the patients into the polyglactin (n = 10) and nylon (n = 21) groups respectively. Overall, 29 patients were available for follow-up while using the abridged 5-item version of the International Index of Erectile Function ( IIEF-5) scoring system, with 21 patients in the nylon group. We have found cavernosography a practical and reliable method to objectively assess penile morphology in these patients. The penile morphology both subjectively and objectively was excellent in all patients , except for 1 in each group. Erectile function restoration showed a trend of satisfaction in the polyglactin group and based on IIEF-5 was significantly improved in the nylon group (14.2 +/- 3.6 vs 21.9 +/- 2.1, n = 20, P <.001). These results suggest that in penile tunical surgery, fine sutures such as 6-0 nylon may result in better penile morphology and functional outcomes.
Subjects
Collagen bundle
outer longitudinal layer penis
tunical alignment
suture material
Other Subjects
collagen; nylon; phosphodiesterase V inhibitor; polyglactin; prostaglandin E1; suture material; vasoactive agent; adult; article; cavernosography; clinical article; erectile dysfunction; follow up; human; International Index of Erectile Function; male; penis disease; penis erection; penis glans; priority journal; scoring system; suture; treatment outcome; tunica albuginea; Adult; Collagen; Genital Diseases, Male; Humans; Male; Nylons; Penile Erection; Penis; Polyglactin 910; Suture Techniques; Sutures; Treatment Outcome; Vascular Surgical Procedures