(173) Initial Experience with ReSheyP Device for Intraoperative Modeling of Peyronie’s Disease After Placement of a Penile ProsthesisS Mossack, E Desouky, L Levine
- Reproductive Medicine
- Endocrinology, Diabetes and Metabolism
- Psychiatry and Mental health
Manual modeling to correct penile curvature associated with Peyronie's disease (PD) during penile prosthesis has been a recognized procedure since the 1st publication by Wilson et al in 1992. A key component to optimizing results and minimizing complications (i.e. distal urethral laceration) with manual modeling is proper technique. Manual modeling can be technically challenging as the inflated prosthesis must be maintained bent in the direction opposite to the curvature for up to 60-90 seconds and repeated several times. This can be challenging for the operating surgeon with respect to hand fatigue or even accomplishing the adequate modeling pressure. The purpose of this report is to present initial results with ReSheyP, a device designed to facilitate manual modeling in a more controlled fashion to make it easier to perform and potentially less risky than when done simply by hand. In addition, the device can be used in the postoperative setting to resolve residual curvature.
We present on 5 men who underwent placement of an inflatable penile prosthesis with manual modeling using the ReSheyP device. Pre- and post-modeling curvature measurement was performed with a goniometer. Men who had severe indentation deformity were excluded from the study.
A retrospective review was performed on patients who underwent penile prosthesis placement followed by ReSheyP modeling in 2023. During the procedure, the ReSheyP was deployed at least 2-3 times for 60-90 seconds per modeling. Data collection included demographics, pre- and post-operative assessment of penile curvature, adverse events and patient satisfaction with postoperative straightening.
Mean pre-modeling curvature was 62 degrees (range 50-70 degrees) (Table 1). Direction of curvature was dorsal in 3 patients and lateral in 2 patient. The average intraoperative post ReSheyP modeling curvature was 11 degrees and the average change in curvature was 45 degrees. All men reported satisfaction with post-op curve correction. There were no intraoperative or postoperative complications. No patient has felt that further at home modeling was needed. Penile sensation and prosthesis function was uncompromised.
This pilot study using the ReSheyP device for intraoperative modeling to correct penile curvature after penile prosthesis placement suggests that this tool may be an effective procedure for correcting penile curvature in men with PD. Further experience is necessary and longer follow-up will be reported.
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.