Surgery for Peyronie disease: Why technique matters

Author(s):

Key Takeaways

Long-term outcomes of Peyronie's surgery include significant penile length loss and erectile dysfunction, with 85% reporting length loss up to two years post-surgery.
Surgical techniques impact outcomes; plication leads to more length complaints, while incision and grafting result in higher erectile dysfunction rates.
Persistent issues like changes in sensation and palpable knots affect approximately 20% of patients two years after surgery.

"The biggest complaint we saw, as far as negative outcomes, was loss of length," says Landon Trost, MD.

In this video from the 2024 Sexual Medicine Society of North America Fall Scientific Meeting, Landon Trost, MD, discusses long-term outcomes of surgical interventions for Peyronie disease. Trost is the founder and director of the Male Fertility and Peyronie’s Clinic in Orem, Utah.

Transcription:

Although surgical interventions can offer immediate benefits for Peyronie's disease, what are the long-term outcomes in terms of curvature correction, erectile function, and patient satisfaction? Are there specific surgical techniques or patient factors that influence these outcomes?

Surgery has been around for 50 to 60 years, or much longer, probably, from a Peyronie standpoint, but the long-term side effects really haven't been studied. There's only 1 long-term study that had ever been done on it. So we started a randomized control trial about 3 years ago, and we're getting further into it at this point where we did trace those types of outcomes over time to see what the true rates of side effects were. The biggest complaint we saw, as far as negative outcomes, was loss of length. About 85% of the guys continued to complain of loss of length, even all the way out to 2 years with it. The other big complaint was erectile dysfunction, changes in sensation, and then the palpability of knots that are present with surgery. Those tend to get a little bit less over time, but they still are present, probably about 20% all the way out to 2 years.

The technique itself does matter. With Peyronie disease, you basically have 3 main surgical techniques. One is plication, where you put stitches on the opposite. Another is incision and grafting, and then another is placement of a prosthesis. Between those first 2, if you just plicate someone, you tend to get more complaints of length, but less impacts on erections. If you do the incision and grafting, you definitely see a much higher rate of erectile dysfunction, but fewer complaints, albeit still complaints, about length. So they each have their own kind of profile of advantages and disadvantages.

This transcript was AI generated and edited by human editors for clarity.