Long-Term Surgical, Functional, and Patient Reported Outcomes of a Modified Corporoplasty: A Tertiary Referral Center Experience

Background: Nesbit corporoplasty was proposed to address penile curvature (PC), both congenital (CPC) and acquired (APC). Aim: To evaluate surgical, functional, and patient reported outcomes (PROs) of a modified corporoplasty. Methods: From May 2005 to January 2017, a consecutive series of patients underwent a modified corporoplasty. Data were retrospectively extrapolated. Intra and postoperative complications and hospital stay were recorded as surgical outcomes. 2 validated international questionnaires were administered preoperatively and at 12 months after surgery: International Index of Erectile Function and Sexual Encounter Profile (items 2-3). An "ad hoc" questionnaire was utilized to assess PROs. Outcomes: Postoperative surgical and functional outcomes and PROs were the primary outcomes assessed in this study. Results: 87 out of 145 patients had complete data available and were included in the study. CPC was noted in 61 patients whilst APC, secondary to Peyronie's disease, was present in 26 patients. Median preoperative PC was 60 degrees (interquartile range [IQR] 45-70). Functional and PROs were evaluated 12 months after surgery for all enrolled patients. Considering surgical outcomes, the median follow-up time was 110 months (IQR 27-132.5). Median operative time was 130 minutes for CPC (IQR 115-150) and 120 minutes for APC (IQR 95-140). Median hospital stay was 2 days for both groups (IQR 1-2). After the median follow-up time of 110 months (IQR 27-132.5), a recurrent curvature was observed in 9.2% of cases. Minor residual curvature (<20 degrees) was detected in 13.8%. International Index of Erectile Function and Sexual Encounter Profile 2-3 scores improved in both groups. Long-term de novo postoperative erectile dysfunction was observed in 3.2% of CPC cases and in 38.5% in APC (P = .001). A multivariate analysis revealed that etiology (APC), patient age (>35 years), and postoperative complications represented independent risk factors for the development of postoperative erectile dysfunction. Postoperative complications, in terms of bleeding, infection, or poor esthetic wound healing, occurred in 12.6% of patients. No Clavien-Dindo grade III-IV intraoperative complications were reported. Postoperative hematoma was more frequent in CPC when compared to APC (P =.003). In relation to PROs, 26.4% of patients responded as being dissatisfied with postoperative penile length, with a higher incidence in the APC group (P =.001). Overall, a significant improvement in everyday and sexual life quality was observed in both categories. Clinical Implications: The modified corporoplasty described showed better residual curvature rates, whilst maintaining similar PROs even if APC patients reported less favorable outcomes when compared to CPC. Strengths & Limitations: The primary limitations of this study are its retrospective nature, no objective evaluation of postoperative curvature, and no penile length assessment. Conclusion: The aforementioned corporoplasty may represent an excellent option for PC correction, with low complication rate and high patient satisfaction. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.