Influence of Penile Rehabilitation on the long-term results of Plaque Incision and Grafting in patients with Peyronie’s Disease

Introduction : The role of penile rehabilitation after surgical treatment of Peyronie’s disease remains debatable to this day. Objectives : to evaluate the impact of penile rehabilitation on the long-term results of plaque incision and grafting in patients with Peyronie’s Disease. Materials and Methods : a single-center, prospective, observational, uncontrolled study included 44 patients who underwent plaque incision and grafting in the period from 2012 to 2021. During the control examination, the state of erectile function was assessed using the IIEF-5 questionnaire, the presence or absence of postoperative complications (paresthesia of the glans penis, shortening of the penis, recurrence of curvature), and it was also clarified about the methods of penile rehabilitation that the patient used in the postoperative period (inhibitors phosphodiesterase type 5 use, vacuum therapy, traction therapy). Patients before surgery and during control examination underwent penile doppler ultrasound with pharmacological test (Alprostadil 10 mcg). 26 patients came to the follow-up examination. 18 patients were excluded from the study due to refusal to participate further. Patients were divided into two groups depending on the use of penile rehabilitation methods. The first group included 10 (38.5%) patients who did not use any of the recommended methods of penile rehabilitation in the postoperative period. The second group included 16 (61.5%) patients who used at least one of the recommended methods of penile rehabilitation. Results : the groups were comparable in terms of the main characteristics. The median follow-up period was 77 months in the first group and 94.5 months in the second group. The highest compliance was noted with regard to the use of PDE-5 inhibitors (100% of patients in the second group) and vacuum therapy (68.75% of the second group). In the first group, the frequency of venogenic dysfunction according to penile doppler ulrtasound was statistically significantly higher (p = 0.03). In the second group (patients who used penile rehabilitation methods), the IIEF-5 score was statistically significantly higher (p = 0.006), and the incidence of penile shortening and curvature recurrence was statistically significantly lower (p = 0.001 and p = 0.01, respectively). Conclusion : penile rehabilitation significantly improves the long-term functional results of plaque incision and grafting in patients with Peyronie’s disease.