%0 Journal Article
%T Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction
%A Luigi Cormio
%A Paolo Massenio
%A Giuseppe Di Fino
%A Giuseppe Lucarelli
%A Vito Mancini
%A Giuseppe Liuzzi
%A Giuseppe Carrieri
%J Case Reports in Urology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/818623
%X Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile ¡°modelling¡± over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. 1. Introduction Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy [1]. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile ¡°modelling¡± over the inflated prosthesis has been introduced as an effective treatment [2¨C4]. However, this procedure is not effective in all cases and involves a 4% risk of urethral laceration [3]. Tunical incisions, with or without grafting, have been used to correct residual curvatures after penile modelling; however, they involve increased morbidity, particularly in terms of hematoma and infection [5¨C7]. In 2004, Rahman et al. [8] described a simplified technique for correcting severe penile curvature and erectile dysfunction using combined penile plication and placement of an inflatable penile prosthesis. Herein, we report for the first time the long-term results of a patient we treated with this procedure. 2. Case Report A 60-year-old Caucasian man underwent bilateral nerve-sparing open retropubic radical prostatectomy because of a pT1c Gleason 7 prostate cancer. His preoperative International Index of Erectile Function-5 (IIEF-5) score was 21. Both operative course and postoperative course were uneventful. Final pathology revealed a pT2cN0 prostate cancer Gleason 7 with three positive surgical margins. He therefore received adjuvant radiotherapy. Following such treatments, he noticed a progressive deterioration of his erectile function, despite the use of phosphodiasterase-5 (PDE-5) inhibitors and intracavernous injection (ICI) with prostaglandin E1 (PGE1), with progressive dorsal penile curvature. At three-year follow-up, his prostate specific
%U http://www.hindawi.com/journals/criu/2014/818623/