Surgery for Induratio Penis Plastica: The patient's opinion [Chirurgia dell'lnduratio Penis Plastica: Cosa ne pensano i pazienti]

Background and aims. Aim of the study was to evaluate pre-operative expectations of patient's suffering from Induratio Penis Plastica (IPP) and their grade of satisfaction following surgery. Methods. Between June 2004 and June 2007, 82 patients who had undergone surgery for IPP were asked to fill out a questionnaire that was specific for the surgery performed. All patients presented a stable IPP plaque, difficulty in having sexual intercourse and, in 16 cases, a concomitant moderate to severe erectile dysfunction. The questionnaire presented is divided in two parts: the first part evaluates the patient's expectations and their psychological attitude towards their illness and the proposed surgery. The second part evaluates results and - if present - the grade of satisfaction regarding surgical outcome. A total of 18 patients underwent plaque surgery with patch placement (8 vena safena, 6 bovine pericardium and 4 suine intestinal submucosa). 48 patients were treated by Nesbit corporoplasty. In 16 patients a penile prosthesis was positioned (8 malleable) 4 hydraulic and 4 soft tutors). Results. Maximum grade of satisfaction was obtained by Nesbit corporoplasty (82%), while patch positioning gave the least satisfactory results. Furthermore, with regard to surgical outcome at follow-up, Nesbit corporoplasty seems to be the most well accepted technique and also the one with less psychological side effects even if the penile shortening that results from this technique considered as a negative aspect by some patients. However, in the majority of cases, a high level of satisfaction was recorded in patients having sexual intercourse, both after Nesbit, as well as after prosthetic surgery. Conclusions. In our opinion, Nesbit corporoplasly should be considered the first choice treatment for IPP. If this is not possible, it is advisable to propose placement of a penile prosthesis, although this requires careful pre-operative counselling.