Introduction: Inflatable penile prosthesis (IPP) insertion is an effective treatment for men with erectile dysfunction and Peyronie’s disease. Most literature on this subject focuses on the utility of adjunct curvature correction maneuvers after IPP placement. There has been little investigation regarding the degree to which the implant alone improves penile curvature prior to the implementation of adjunct curvature correction maneuvers.
Objective: The primary objective was assessing the impact of IPP on known penile curvature immediately after insertion. Secondary objectives were changes in penile curvature after adjunct curvature correction maneuvers and postoperatively.
Methods: This is an IRB-approved (IRB 00031589) retrospective series of all IPP patients with known preoperative penile curvature undergoing IPP placement with a single surgeon from January 2017 to June 2023. Extensive investigation of available patient chart information was conducted. All patients had a 3-piece Coloplast Titan Touch IPP (Coloplast, Minneapolis, MN, USA) ranging 16-24cm in length (mean 19.8 ± 1.9cm) with 0-3cm rear tips (mean 1.4 ± 0.9cm). Goniometer was used to assess curvature during preoperative intracavernosal injection and duplex Doppler ultrasound, at multiple points intraoperatively, and postoperatively at 2 weeks, 6 weeks, and 6 months. Biplanar curvatures were recorded as primary and secondary values. SPSS (IBM, Armonk, NY, UA) was used for statistical analyses, which included t-tests, chi-squared tests, and ANOVA.
Results: Sixty-one patients were included. Mean known primary preoperative curvature was 40° ± 16° (10 to 80°). IPP placement prior to adjunctive maneuvers resulted in 21° ± 10° absolute reduction in primary penile curvatures, corresponding to a 52% ± 26% improvement (50° reduction to 5° worsening). Dorsal curvatures improved by 21° ± 8° (51% ± 17%, 40° to 5° reduction) with IPP alone. Ventral curvatures improved by 24° ± 18° (49% ± 51%, 50° reduction to 5° worsening) with IPP alone. Lateral curvatures improved by 19° ± 10° (54% ± 24%, 40° to 0° reduction) with IPP alone. Eight patients had resolution of primary curvature with IPP alone, with mean preop curves 32° ± 11° (range 15° to 50°). Three of these needed modeling for secondary curvatures, leaving five total who did not require adjunct curvature correction maneuvers. Subsequent modeling for all patients resulted in 14° ± 9° absolute reduction in primary penile curvatures and up to 68% further improvement. Sample size precluded assessment of statistical significance among groups.
Conclusions: IPP placement appears to correct approximately 20° of penile curvature in this series, with similar effect on all curvature directions. These data may help clarify patient preoperative counseling and guide surgical planning. Further multicenter studies incorporating more patients and additional IPP types are warranted.
