Long-Term Outcomes of Surgery for Peyronie's Disease: Focus on Patient Satisfaction - Beyond the Abstract

While this paper is dedicated to the outcomes of surgery for Peyronie’s disease, it seems that the greatest challenge in the management of this condition lies not in surgical technique, but in patient counseling. The patient may have a minor penile curvature coupled with major psychological problems, which won’t be resolved after surgery that may sometimes become aggravated. It is better to avoid surgery altogether when dealing with penile curvature which doesn’t impede coitus. However, some patients keep insisting on intervention and remain unsatisfied with their results after the surgeon finally yields to their demands. This group of patients, most of them being dysmorphophobic, are very difficult to manage.

As we have learned from our experience, some patients refrain from sexual activity even after nominally successful corporoplasty for various reasons. Surgery shouldn’t be offered to patients who are not planning to be sexually active, but it may be tricky to identify them, as some men tend to over-emphasize the importance of sex in their personal lives. In addition, patients should be actively informed that there is no proven association between Peyronie’s disease plaques and penile cancer as unvoiced carcinophobia sometimes drives their decision to undergo unnecessary surgery.
It is important to set adequate patient expectations. No surgery will make the penis anatomically perfect. Our goal is to make patients able to have sexual intercourse without discomfort, and the patient should know that prior to making a decision.

Doctors' satisfaction with corporoplasty outcomes doesn’t necessarily mean that patients are satisfied with treatment results. Surgical "heroism" often goes unrewarded, while open and honest discussion is necessary for success in the management of Peyronie’s disease.

Written by: Safar Gamidov, MD, Taras Shatylko, MD, Natig Gasanov, Dmitriy Scherbakov, Konstantin Li, Gennadiy Sukhikh, MD, PhD, Sechenov University, Moscow, Russia, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow, Russia

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