Impact of follow-up on results of surgery for Peyronie’s disease: Time matters

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European Association of Urology (EAU) - Events - Abstracts online

Impact of follow-up on results of surgery for Peyronie's disease: Time matters
Wimpissinger, F., Frank, S., Stackl, W.
Rudolfstiftung Hospital, Dept. of Urology, Vienna, Austria
Introduction & Objectives

Surgery is the mainstay of therapy for chronic stable Peyronie's disease (Peyronies Disease) with severe curvature of the penis. Contemporary procedures have comparable, favourable results based on relatively short follow up periods. However, long term follow up is rarely reported.
Material & Methods

Results of plaque incision and autologous venous grafting have been investigated during two time points with clearly different follow up time periods.
Results

Follow up period of study I – conducted between 1992 and 1999 – was 38 months (18-73mo) and included 37 patients. Study II (1992-2008) included 38 partly different patients that have been followed for a mean of 9.3years (=111.6 months; +/- 5.2 years). Outcome measures were postoperative curvature/recurrence – study I: 0.0%, study II: 23.7%. postoperative erectile dysfunction (ED) – study I: 3.0%, study II: 39.5%. Penile shortening – study I: 0.0%, study II: 65.8%. Impairment of penile sensibility – study I: 3.0%, study II: 31.4%.
Conclusions

Outcome measures clearly differed according to length of follow up. Two factors seem to negatively impact outcome results of Peyronies Disease surgery: 1) Peyronies Disease is a chronic disease that is not cured with surgery (or any other contemporary treatment strategy). 2) Longer time of follow up equals higher age of patients at data acquisition. This clearly increases the rate of patients with ED and impaired sensibility and sexual function.

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Highlights inserted by myself. Translation of the study in simple english: There were two sets of people (37 and 38 patients respectively, some unspecified number in the intersection of both sets) who each had the grafting surgery. The first group was followed after operation for up to 3 years.
The number of people with recurrence of curvature, erection problems, penis shortening and loss of sensitivity was extremely low.

The second group was followed much longer for 9 years. Here after this period of time there was severe increase in
recurrence in almost 1/4 of the patients, almost 2/3 had penile shortening, almost 1/3 some loss of sensation and more than 1/3 had erection problems.

Part of this can be explained away with age: People followed longer tend to be older therefore might have some erection problems. Doesn't explain the recurrence rate in curvature though.
"Without health life is not life; it is only a state of languor and suffering - an image of death."

Norm

These are some interesting results. We need more and larger studies like this. I just had surgery and fully understand that I did not receive a cure, only a correction. If it is temporary, I understand. I am 64 years old. I would consider myself fortunate to be able to stay straight for another three to nine years. By then, I probably won't care. With this said, I will be the first to say that we need more research in order to help the younger guys who have a whole lifetime to live with this. Right now, there is no cure. There is only the compromise of a correction. We need to change that.  
Plication Surgery Dec. 2013. Straight Again!