Absorbable versus Non-Absorbable Sutures in Plication Surgery for Penile Curvature: A Comparison of Outcomes

BACKGROUND Peyronie's disease is a fibrotic disorder of the tunica albuginea that causes penile curvature and sexual dysfunction. Plication surgery is a standard treatment for men with preserved erectile function; however, non-absorbable sutures may lead to palpable and bothersome nodules.

OBJECTIVE To compare surgical and patient-reported outcomes between absorbable and non-absorbable sutures in penile plication surgery.

METHODS This retrospective study included 48 patients who underwent plication surgery between 2013 and 2023 and completed long-term follow-up. Twenty-nine (60.4%) received absorbable sutures and 19 (39.6%) non-absorbable sutures. Mean follow-up was 8.4 ± 2.9 vs 4.0 ± 1.2 years (p < 0.001). Primary outcomes were surgical success (no residual curvature) and bothersome nodularity, both self-reported. Univariate and multivariable logistic regression identified predictors of these outcomes.

RESULTS Surgical success rates were comparable (62.1% vs 63.2%; p = 0.94). Bothersome nodularity was significantly less frequent with absorbable sutures (6.8% vs 36.8%; p = 0.02). On multivariable analysis, non-absorbable sutures remained the strongest predictor of bothersome nodularity (adjusted OR 18.0; 95% CI 1.36-642; p = 0.057), while no independent predictors of surgical success were identified.

CONCLUSIONS Absorbable sutures reduce bothersome nodularity without compromising surgical outcomes, suggesting improved postoperative comfort with comparable efficacy.