PROGNOSTIC FACTORS OF SATISFACTION WITH ERECTILE FUNCTION IN PEYRONIE’S DISEASE

Objective: To determine the prognostic factors of satisfaction with erectile function in Peyronie’s disease. Materials and methods: 342 patients with Peyronie’s disease who underwent corporoplasty were analyzed. Mean age of patients at time of surgery was 42.4±15.6 years (range: 28-72 years). Median follow-up was 9.5 years (range: 0.5-20 years). Average preoperative penile curvature was 68±28, and mean stretched penile length was 12.4±3.1 cm. A logistic regression model was built to identify predictors of complete satisfaction with erectile function (EF). The analysis includes factors related to the patient, Peyronie’s disease, and the surgical method. The results are presented as the odds ratio (OR) and 95% confidence interval (95% CI). A factor was considered to be a significant independent predictor of an outcome if p value < 0.05. Results: Among patients who were included in final analysis, only 285 (83.3%) were sexually active at long term. Among 285 sexually active patients, 139 (40.6%) were completely satisfied with EF, 84 (24.6%) were relatively satisfied, and 62 (18.1%) were dissatisfied. Median IIEF-EF score (+interquartile range) was 24+5. Seven patients (2%) only had rare sexual encounters and 50 patients (14.6%) had no sexual activity due to treatment for prostate cancer, severe refractory erectile dysfunction, or non-medical reasons. Preoperative IIEF score, tunica albuginea plication, and substitution corporoplasty with venous autograft or cadaveric pericardium allograft were significant predictors of complete satisfaction with EF outcome on regression analysis. No negative predictors were found according to the regression model. Conclusion: A high preoperative IIEF-EF score is a positive predictor of satisfaction with erectile function. Despite the high satisfaction rate after substitution corporoplasty and tunica albuginea plication, it is necessary to inform patients about the possible negative influence of concomitant factors and the risk of erectile dysfunction, regardless of the method of treatment.

Peyronie’s disease, corporoplasty, erectile function, satisfaction