Our analysis included 88 patients who underwent the procedure between 2016 and 2024, all presenting with severe curvature (>60°) and preserved erectile function. We focused on objective measures—correction of curvature, stretched penile length (SPL), and erectile function—as well as patient-reported outcomes and complications.
Key Findings and Reflections:
- Effectiveness: We observed an effective correction of curvature in the majority of patients, with a low rate of surgical site infections (2.3%) and hematomas (8.0%). Most notably, penile length increased objectively in nearly all patients, with a median SPL gain of 1.0 cm, and no cases required surgical reintervention.
- Erectile Dysfunction (ED): Despite promising surgical outcomes, postoperative ED was our most significant finding, affecting 38.6% of patients. This high rate, though comparable to other series using graft materials, underscores the delicate balance between curvature correction and preservation of erectile function. Most cases responded to oral PDE5 inhibitors, though 3.4% eventually required penile prosthesis implantation.
- Patient Perception vs. Objective Data: Interestingly, a subset of patients (9.1%) reported perceived penile shortening postoperatively, despite objective data showing lengthening. This highlights the importance of setting realistic preoperative expectations and underscores the subjective nature of surgical satisfaction in PD management.
- Advantages of TachoSil®: As a sutureless collagen fleece graft, TachoSil® provides unique advantages—shorter operative times, reduced manipulation of delicate structures, and minimal palpable nodules postoperatively. These benefits may help reduce surgical morbidity, especially in high-volume or resource-limited settings.
- Technique Variability and Limitations: A key consideration in our study is its multicentric nature—with different surgeons and slightly varied techniques—reflecting real-world diversity but potentially introducing heterogeneity in outcomes. Despite these limitations, our cohort is among the largest focused exclusively on lengthening corporoplasty with collagen fleece and without simultaneous prosthesis placement.
This study reinforces TachoSil® as a viable graft material for lengthening corporoplasty in PD. However, the relatively high rate of ED postoperatively, even in a carefully selected cohort, suggests that surgical correction should always be accompanied by thorough counseling and discussion of treatment alternatives, including simultaneous prosthesis placement for select patients.
Future research should prioritize prospective comparative trials with validated quality-of-life metrics and longer-term sexual function assessments. As PD management evolves, integrating patient-centered outcomes with surgical data remains critical to improving care in this highly sensitive and impactful domain of men’s health.
Written by: Alberto Costa Silva, Centro Hospitalar Universitário São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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