A nationwide multicentric analysis of lengthening corporoplasty with collagene fleece in Peyronie's disease.

Abstract

Lengthening corporoplasty is recommended for Peyronie's disease (PD) patients with severe (>60°) or complex curvature and preserved erectile function. This study aimed to evaluate lengthening corporoplasty outcomes using a graft of collagen fleece in Portugal. A multicentric retrospective study included PD patients who underwent the procedure between 2016 and 2024 at four Portuguese hospitals. Among 88 patients, the median age (IQR) was 59.0 (56.0-63.0) years, International Index of Erectile Function-5 (IIEF-5) score 22.5 (22.0-23.0), stretched penile length (SPL) 13.0 (12.0-14.0) cm, and curvature angle 80.0° (78.8-90.0)°. Dorsal curvature was most common (65.9%) and the median surgery duration was 92.5 (80.0-106.3) min. Early postoperative hematoma occurred in 8.0% of cases, and 2.3% had surgical site infections. No surgical reinterventions were needed. After a median follow-up of 31 months, complications included erectile dysfunction (38.6%), residual curvature (19.3%), reduced penile length (9.1%), penile pain (8.0%), and glans hypoesthesia (5.7%). SPL was 13.8 (12.5-15.0) cm immediately postoperative and 14.0 (13.0-15.0) at 1 month. New-onset erectile dysfunction treatments included phosphodiesterase type 5 inhibitors (34.1%), intracavernous alprostadil (1.1%), and penile prosthesis (3.4%). This study demonstrates effective curvature correction but high rates of postoperative erectile dysfunction, often requiring treatment.