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Background <p>To 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.</p> Results <p>The cohort comprised 101 men (Nesbit = 31, Yachia = 70). Nesbit patients were younger (55 vs 59.7&#xa0;yr;&#xa0;<i>p</i> = 0.02) and had greater baseline curvature (55° vs 45°;&#xa0;<i>p</i> = 0.01). Every case was surgically successful (residual curvature &lt; 20° in 100%, &lt; 10° in 58% overall, <i>p</i> = 0.66). Yachia procedures were shorter (45 vs 71&#xa0;min;&#xa0;<i>p</i> &lt; 0.05) but required &gt; 2 plications more often (41% vs 7%;&#xa0;<i>p</i> = 0.01).</p> <p>The PRO survey had a 74.3% response rate, with a median follow-up of 5&#xa0;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 (<i>p</i> = 0.35).</p> <p>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 (<i>p</i> = 0.60). The most frequent cause of dissatisfaction was perceived penile shortening, reported by 85% of men.</p> <p>Erectile function declined postoperatively in 30% of Yachia and 15% of Nesbit patients (<i>p</i> = 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.</p> Conclusions <p>Both 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.</p>

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Comparison of long-term patient reported outcomes of excisional and incisional corporoplasties for Peyronie’s disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月9日

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  • Patrick Daniel Preece,
  • Varun Sahdev,
  • Paul Gerard Davis,
  • Rowland Wyn Rees

摘要

Background

To 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.

Results

The 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.

Conclusions

Both 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.