Preoperative Clinical and Diagnostic Characteristics of Patients Who Require Delayed IPP after Primary Peyronies Repair

Authors

  • Hannah H. Alphs MD,

    1. Northwestern University Feinberg School of Medicine, Department of Urology, Chicago, IL, USA;
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  • Neema Navai MD,

    1. Northwestern University Feinberg School of Medicine, Department of Urology, Chicago, IL, USA;
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  • Tobias S. Köhler MD,

    1. Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
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  • Kevin T. McVary MD

    Corresponding author
    1. Northwestern University Feinberg School of Medicine, Department of Urology, Chicago, IL, USA;
      Kevin T. McVary, MD, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Tarry 16-703, Chicago, IL 60611-3008, USA. Tel: 312-908-8145; Fax: 312-908-7275; E-mail: k-mcvary@northwestern.edu
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  • Authors affirm that no funding agreement limits their ability fairly to complete and publish their research/study, and all had full control of primary data.

Kevin T. McVary, MD, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Tarry 16-703, Chicago, IL 60611-3008, USA. Tel: 312-908-8145; Fax: 312-908-7275; E-mail: k-mcvary@northwestern.edu

ABSTRACT

Introduction.  Penile vascular abnormalities occur in a high proportion of patients with Peyronie's disease (PD). Penile duplex ultrasonography (PDU) and dynamic infusion cavernosometry and cavernosography (DICC) are tools that can be used to help tailor individualized treatment for patients undergoing surgical intervention for their PD. However, precisely which parameters can be used to predict those patients with PD at risk for developing erectile dysfunction (ED) after intervention without inflatable penile prosthesis (IPP) has not been previously elucidated.

Aim.  To evaluate preoperative vascular parameters that predispose PD patients for developing ED after intervention without IPP.

Methods.  Twenty-six patients receiving surgical intervention for their PD at a single center were retrospectively identified. Of these, 11 (42.3%) opted for primary repair without placement of an IPP. Three (27.2%) of these 11 patients went on to develop ED postoperatively.

Main Outcome Measures.  We compared various demographic, PDU, and DICC parameters between patients who did and did not fail primary repair of their PD.

Results.  Mean age and follow-up of patients who went on to develop ED after repair of PD without IPP were not significantly different (P < 0.05). Resistive index (RI) and end diastolic volume were significantly different between these two groups (P < 0.05), while peak systolic volume, flow to maintain, and pressure decay were not significantly different. An RI cutoff of <0.80 was found to identify all patients who would later develop ED and fail primary repair without IPP.

Conclusions.  Penile vascular assessment can aid in counseling patients about their risk of developing delayed ED after primary repair of PD. In our cohort of patients, PDU provided preoperative risk stratification for postoperative erectile dysfunction in men undergoing Peyronie's repair without IPP. We propose the prospective study of an RI cutoff to identify patients at risk of failing primary PD repair without IPP. Alphs HH, Navai N, Köhler TS, and McVary KT. Preoperative clinical and diagnostic characteristics of patients who require delayed IPP after primary peyronies repair. J Sex Med 2010;7:1262–1268.

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