Shafik A, Shafik I, El Sibai O, Shafik A A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, 2 Talaat Harb Street, Cairo 11121, Egypt.
Andrologia. 2005 Oct;37(5):180-4. doi: 10.1111/j.1439-0272.2005.00678.x.
Tunica albuginea (TA) in venogenic erectile dysfunction (VED) was found subluxated and flabby because of degeneration and atrophy of its collagen fibres. This had apparently led to derangement of TA veno-occlusive mechanism. We investigated the hypothesis that overlapping of the subluxated and flabby TA would achieve a competent veno-occlusive mechanism during erection. Tunical overlapping was performed in nine VED patients (age 35.6 +/- 1.6 years). Intracorporal pressure (ICP) was measured pre- and postoperatively. After penile degloving, TA on lateral penile aspect was divided along whole length of corpus cavernosum (CC) and tunical double-breasting for 1-1 1/2 cm was performed. A biopsy was taken from TA and stained with haematoxylin and eosin and Masson's trichrome. Clinical efficiency of the operation was evaluated after 6 months. ICP increased (P < 0.01) postoperatively in the nine patients. The increase was maintained during follow-up period in eight patients and decreased to preoperative level in one. Six months after operation, the eight patients had significantly (P < 0.01) improved scores for the erectile function domain over the preoperative scores. Microscopic examination of TA biopsies showed atrophy of the collagen fibres. Tunical overlapping aims at correction of TA flabbiness, corporal tissue support and improving of veno-occlusive mechanism.
在静脉性勃起功能障碍（VED）中，白膜（TA）因胶原纤维退变和萎缩而出现半脱位且松弛。这显然导致了白膜静脉闭塞机制紊乱。我们研究了一个假设，即半脱位且松弛的白膜重叠在勃起过程中可实现有效的静脉闭塞机制。对9例VED患者（年龄35.6±1.6岁）进行了白膜重叠手术。术前和术后测量海绵体内压（ICP）。阴茎脱套后，沿阴茎海绵体（CC）全长切开阴茎侧面的白膜，并进行1 - 1.5厘米的白膜双层缝合。从白膜取活检组织，用苏木精 - 伊红和马松三色染色法染色。6个月后评估手术的临床疗效。9例患者术后ICP升高（P < 0.01）。8例患者在随访期间ICP升高得以维持，1例降至术前水平。术后6个月，8例患者勃起功能领域的评分较术前显著提高（P < 0.01）。白膜活检组织的显微镜检查显示胶原纤维萎缩。白膜重叠旨在纠正白膜松弛、支撑海绵体组织并改善静脉闭塞机制。
