https://doi.org/10.4081/aiua.2024.12957
Altieri modified Nesbit corporoplasty for the treatment of penile curvature: Comparison of local anesthesia vs. loco-regional anesthesia on the clinical outcomes
Submitted: August 23, 2024
Accepted: August 31, 2024
Published: October 29, 2024
Accepted: August 31, 2024
Abstract Views: 562
PDF: 149
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective: To compare the safety profile and clinical outcomes of Altieri-modified Nesbit corporoplasty using two different anesthesia methods including spinal anesthesia and local anesthesia.
Materials and methods: A total of 40 patients with congenital penile curvature (CPC) and Peyronie’s disease (PD) underwent Altieri-modified Nesbit corporoplasty. Group 1 (n = 20) received spinal anesthesia, and Group 2 (n = 20) received local anesthesia. The patients were categorized into age groups (< 30 years, 31-45 years, 46-60 years, and 61-75 years) for analysis. Clinical outcomes, post-operative complications, hospital stay, pain levels, and other parameters were assessed.
Results: The results showed that 2 patients (10%) reported postoperative complications, including headache, arterial hypotension, and penile foreskin necrosis from the spinal anesthesia group. Whereas, in the local anesthesia group, 1 patient (5%) reported scar phimosis. Further, post-operative pain was predominantly very mild, with 16 patients (80%) in the spinal anesthesia group and 14 patients (70%) in the local anesthesia group experiencing minimal discomfort. Age did not significantly impact hospital stay, post-operative intestinal disorders, constipation, lower urinary tract symptoms, voiding burning, or dysuria.
Conclusions: Spinal anesthesia may lead to more post-operative complications and longer hospital stays compared to local anesthesia. Age does not significantly affect most clinical outcomes but can influence post-operative pain in patients receiving local anesthesia.
Montag S, Palmer LS. Abnormalities of penile curvature: chordee and penile torsion. ScientificWorldJournal. 2011; 11:1470-8.
El-Sakka AI. Prevalence of Peyronie's disease among patients with erectile dysfunction. Eur Urol. 2006; 49:564-9.
Spirito L, Manfredi C, La Rocca R, et al. Daily low-dose tadalafil may reduce the penile curvature progression rate in patients with acute Peyronie's disease: a retrospective comparative analysis. Int J Impot Res. 2024; 36:129-134.
Spirito L, Manfredi C, La Rocca R, et al. Long-term outcomes of extracorporeal shock wave therapy for acute Peyronie's disease: a 10-year retrospective analysis. Int J Impot Res. 2024; 36:135-139.
Kadioglu A, Sanli O, Akman T, et al. Factors affecting the degree of penile deformity in Peyronie disease: an analysis of 1001 patients. J Androl. 2011; 32:502-8.
Nehra A, Alterowitz R, Culkin DJ, et al.; American Urological Association Education and Research, Inc.,. Peyronie's Disease: AUA Guideline. J Urol. 2015; 194:745-53.
Brimley SC, Yafi FA, Greenberg J, et al. Review of Management Options for Active-Phase Peyronie's Disease. Sex Med Rev. 2019; 7:329-337.
Carson CC, Levine LA. Outcomes of surgical treatment of Peyronie's disease. BJU Int. 2014; 113:704-13.
Egydio PH, Sansalone S. Peyronie's reconstruction for maximum length and girth gain: geometrical principles. Adv Urol. 2008; 2008:205739
Chung E, Ralph D, Kagioglu A, et al. Evidence-Based Management Guidelines on Peyronie's Disease. J Sex Med. 2016; 13:905-23.
Hatzimouratidis K, Eardley I, Giuliano F, et al. European Association of Urology. EAU guidelines on penile curvature. Eur Urol. 2012; 62:543-52.
Langston JP, Carson CC 3rd. Peyronie disease: plication or grafting. Urol Clin North Am 2011; 38:207-16.
Nesbit RM. Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol. 1965; 93:230-2.
Sasso F, Vittori M, D'Addessi A, Bassi PF. Penile curvature: an update for management from 20 years experience in a high volume centre. Urologia. 2016; 83:130-138.
Altieri VM, Greco F, Lisanti RC, et al. Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie's disease. Transl Androl Urol. 2021; 10:2857-2870.
Rocco G. Non-intubated uniportal lung surgery†. Eur J Cardiothorac Surg. 2016; 49(Suppl 1):i3-5.
Furák J, Szabó Z, Horváth T, et al. Non-intubated, uniportal, video assisted thoracic surgery [VATS] lobectomy, as a new procedure in our department. Magy Seb. 2017; 70:113-117.
Callesen T, Bech K, Kehlet H. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia. Anesth Analg. 2001; 93:1373-6
Kehlet H, Aasvang E. Groin hernia repair: anesthesia. World J Surg. 2005; 29:1058-61.
Sungurtekin H, Sungurtekin U, Erdem E. Local anesthesia and midazolam versus spinal anesthesia in ambulatory pilonidal surgery. J Clin Anesth. 2003; 15:201-5
Likert R. A technique for the measurement of attitudes. Archives of Psychology, 1932: 22: 140-55.
Sidhom K, Chung D, Patel P. Case series - Tolerability of penile fracture repair under conscious sedation. Can Urol Assoc J. 2023; 17:E218-E220.
Cuvillon P, Lefrant JY, Gricourt Y. Considerations for the Use of Local Anesthesia in the Frail Elderly: Current Perspectives. Local Reg Anesth. 2022; 15:71-75.
Benzon HT, Asher YG, Hartrick CT. Back Pain and Neuraxial Anesthesia. Anesth Analg. 2016; 122:2047-58.
Ana MM, Carlos FP, Teresa MSM, et al. Corporoplasty under local anesthesia: Cost-effective improvement of the surgical treatment of Peyronie's disease. Rev Int Androl. 2022; 20:231-236.
Stevens RA, Mikat-Stevens M, Flanigan R, et al. Does the choice of anesthetic technique affect the recovery of bowel function after radical prostatectomy? Urology. 1998; 52:213-8.
Celik S, Atar NY, Ozturk N, et al. Constipation Risk in Patients Undergoing Abdominal Surgery. Iran Red Crescent Med J. 2015; 17:e23632.
Stienen MN, Smoll NR, Hildebrandt G, et al. Constipation after thoraco-lumbar fusion surgery. Clin Neurol Neurosurg. 2014; 126:137-42.
Kreutziger J, Frankenberger B, Luger TJ, et al. Urinary retention after spinal anaesthesia with hyperbaric prilocaine 2% in an ambulatory setting. Br J Anaesth. 2010; 104:582-6.
Haleem S, Ozair A, Singh A, et al. Postoperative urinary retention: A controlled trial of fixed-dose spinal anesthesia using bupivacaine versus ropivacaine. J Anaesthesiol Clin Pharmacol. 2020; 36:94-99.
Yilmaz G, Akca A, Kıyak H, et al. Spinal Anesthesia Is Associated With Postoperative Urinary Retention In Women Undergoing Urogynecologic Surgery. Eastern Journal of Medicine 2020; 25:293-298.
Mahan KT, Wang J. Spinal morphine anesthesia and urinary retention. J Am Podiatr Med Assoc. 1993; 83:607-14.
Wang LL, Kang M, Duan LX, et al. Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients. Front Surg. 2023; 9:1077575.
Rossi A, Alei G, Viscuso P, et al. An original mininvasive corporoplasty technique for penile curvature without circumcision. Arch Ital Urol Androl. 2022; 94:334-338.
Sieber FE, Zakriya KJ, Gottschalk A, et al. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc. 2010; 85:18-26.
Neuman MD, Feng R, Carson JL, et al. ; REGAIN Investigators. Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults. N Engl J Med. 2021; 385:2025-2035.
Bafna U, Rajarajeshwaran K, Khandelwal M, Verma AP. A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute post-operative pain after surgery under spinal anesthesia. J Anaesthesiol Clin Pharmacol. 2014; 30:373-7.
Tu C-P, Tsai C-H, Tsai C-C, et al. Postoperative Ileus in the Elderly. International Journal of Gerontology 2014; 8:1-5.
Lang-Illievich K, Bornemann-Cimenti H. Opioid-induced constipation: a narrative review of therapeutic options in clinical management. Korean J Pain. 2019; 32:69-78.
Yılmaz E, Arı M. Impact of Pre-Operative Anxiety on Post-Operative Constipation. Turk J Colorectal Dis 2016; 26:39-46.
Basques BA, Bohl DD, Golinvaux NS, et al. General versus spinal anaesthesia for patients aged 70 years and older with a fracture of the hip. Bone Joint J. 2015; 97-B:689-95.
Hernandez NS, Wang AY, Kanter M, et al. Assessing the impact of spinal versus general anesthesia on postoperative urinary retention in elective spinal surgery patients. Clin Neurol Neurosurg. 2022; 222:107454.
How to Cite
Altieri, V. M., Saldutto, P., Verratti, V., La Rocca, R., Di Mauro, E., Celentano, G., Capece, M., Morgera, V., Cacace, G., Vena, W., Mastrangelo, F., Napolitano, L., & Iacono, F. (2024). Altieri modified Nesbit corporoplasty for the treatment of penile curvature: Comparison of local anesthesia <i>vs.</i> loco-regional anesthesia on the clinical outcomes. Archivio Italiano Di Urologia E Andrologia, 96(4). https://doi.org/10.4081/aiua.2024.12957
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.