ArticleBasic and clinical andrology2025
Comparison of long-term patient reported outcomes of excisional and incisional corporoplasties for Peyronie's disease.
Article in Basic and clinical andrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo compare surgical and long-term patient-reported outcomes (PRO) between excisional (Nesbit) and incisional (Yachia) corporoplasty for correction of uncomplicated Peyronie's-related penile curvature in a large, single-surgeon cohort. A retrospective audit identified men who underwent Nesbit or Yachia corporoplasty (2015-2021). Operative data was extracted from records. A structured telephone survey captured long-term PRO.
resultsThe cohort comprised 101 men (Nesbit = 31, Yachia = 70). Nesbit patients were younger (55 vs 59.7 yr; p = 0.02) and had greater baseline curvature (55° vs 45°; p = 0.01). Every case was surgically successful (residual curvature < 20° in 100%, < 10° in 58% overall, p = 0.66). Yachia procedures were shorter (45 vs 71 min; p < 0.05) but required > 2 plications more often (41% vs 7%; p = 0.01). The PRO survey had a 74.3% response rate, with a median follow-up of 5 years. 'Patient Global Impression of Improvement' scores reflected strong improvement with median scores of 1 ("very much better") and 2 ("much better") in the Nesbit and Yachia groups respectively (p = 0.35). However, this perceived improvement did not translate uniformly into long-term satisfaction. Only 66.7% of respondents reported being "completely" or "mostly" satisfied with the overall outcome (p = 0.60). The most frequent cause of dissatisfaction was perceived penile shortening, reported by 85% of men. Erectile function declined postoperatively in 30% of Yachia and 15% of Nesbit patients (p = 0.03), though this is possibly confounded by the older age of the Yachia cohort. Bothersome curvature recurrence and post-operative cosmesis did not significantly impact satisfaction in either group.
conclusionsBoth Nesbit and Yachia corporoplasties provide effective and durable results with comparable long-term patient satisfaction. Regardless of technique, subjective reporting of penile shortening was particularly pervasive and was highly bothersome. This underscores the need for meticulous pre-operative counselling.
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