Greenfield Jason M, Lucas Steven, Levine Laurence A
Department of Urology, Rush University Medical Center, Chicago, Illinois, USA.
J Urol. 2006 Jan;175(1):238-41. doi: 10.1016/S0022-5347(05)00063-7.
Loss of length is a common postoperative complaint of the patient who undergoes surgical correction of penile curvature. We investigate the factors influencing complications in patients who have undergone TAP for PD and chordee.
A total of 102 patients underwent TAP for PD (68) or chordee (34) between 1997 and 2004. Data were gathered on each patient's preoperative complaints, physical examination, Doppler ultrasound, operative data and postoperative complaints. For the purposes of this study penile length was measured from pubis to corona along the dorsal surface of the stretched phallus.
Mean ages at surgery for men with PD and chordee were 53 and 24, respectively. A range of 1 to 6 plications were performed on each patient (mean 3) with an acceptably straight penis (curve less than 20 degrees) being achieved in 99% of patients. Mean followup for our patient population was 29 months and revealed only 1 patient with residual curvature. The mean loss in length after TAP was 0.36 +/- 0.5 cm with a range of 0 to 2.5 cm. When calculated as a percent of length lost from preoperative length, the postoperative percent length lost was 2.4%. When stratified into groups based on direction of curvature, the patients with ventral or ventrolateral curve had the highest percent loss of length. A 1-way ANOVA of these groups proved the differences between each group to be statistically significant (p = 0.04). Length change also significantly correlated with preoperative stretched penile length and the severity of curvature as measured in degrees in the operating room at time of surgery. Parameters that did not demonstrate a statistically significant impact on penile shortening included patient age, number of plications performed, plaque size, and hinge/narrowing effect due to a PD plaque.
The TAP procedure is a safe and effective means of correcting penile curvature, with similar overall outcomes between patients with PD and chordee. Shortening of the penis does commonly occur but is dependent on direction and degree of curvature, as well as the length of the phallus.
阴茎长度缩短是接受阴茎弯曲手术矫正患者常见的术后主诉。我们研究了影响接受阴茎硬结症（PD）和尿道下裂手术治疗患者并发症的因素。
1997年至2004年间，共有102例患者接受了针对阴茎硬结症（68例）或尿道下裂（34例）的阴茎白膜折叠术（TAP）。收集了每位患者的术前主诉、体格检查、多普勒超声检查、手术数据及术后主诉等资料。在本研究中，阴茎长度是沿着拉伸阴茎的背侧表面从耻骨测量至冠状沟。
阴茎硬结症患者和尿道下裂患者手术时的平均年龄分别为53岁和24岁。每位患者进行了1至6次折叠术（平均3次），99%的患者阴茎达到了可接受的伸直状态（弯曲度小于20度）。我们患者群体的平均随访时间为29个月，仅1例患者存在残余弯曲。阴茎白膜折叠术后阴茎长度的平均缩短为0.36±0.5厘米，范围为0至2.5厘米。以术前长度的长度损失百分比计算，术后长度损失百分比为2.4%。根据弯曲方向分层分组时，腹侧或腹外侧弯曲的患者长度损失百分比最高。对这些组进行单因素方差分析证明，各组之间的差异具有统计学意义（p = 0.04）。长度变化也与术前拉伸阴茎长度以及手术时在手术室测量的弯曲严重程度（以度数表示）显著相关。对阴茎缩短未显示出统计学显著影响的参数包括患者年龄、进行的折叠术次数、斑块大小以及阴茎硬结症斑块引起的铰链/狭窄效应。
阴茎白膜折叠术是矫正阴茎弯曲的一种安全有效的方法，阴茎硬结症患者和尿道下裂患者的总体结果相似。阴茎缩短确实常见，但取决于弯曲的方向和程度以及阴茎的长度。
