Colpi Giovanni, Piediferro Guido, Castiglioni Fabrizio, Contalbi Gianfranco, Carmignani Luca
Andrological Urology Unit, University of Milano, San Paolo Hospital, Milano, Italy.
J Urol. 2009 Oct;182(4):1489-94. doi: 10.1016/j.juro.2009.06.059. Epub 2009 Aug 15.
The technique most widely used to correct congenital ventral penile curvature is still corporoplasty as originally described by Nesbit. We present results in patients treated with a variation of Nesbit corporoplasty used specifically for congenital ventral penile curvature.
From June 2000 to June 2007 we treated 51 patients with congenital ventral penile curvature using modified corporoplasty (septoplasty), consisting of accessing the bed of the penile dorsal vein and excising 1 or more diamonds of tunica albuginea from it, extending in wedge-like formation 4 to 5 mm deep into the septum, until the penis is completely straightened. Patient history, clinical findings, self-photography results and the International Index of Erectile Function score were assessed. Curvature grade is expressed using the equation, 180 degrees - X, where X represents the deviation in degrees from the penis axis. Mean preoperative ventral curvature was 131.4 degrees (median 135, range 145 to 110). Of the patients 13 also had erectile dysfunction.
At followup postoperative mean ventral curvature was 178.3 degrees (median 179.1, range 180 to 175). A total of 49 stated that they were completely satisfied. Penile shortening was 5 to 15 mm. Compared to preoperative values there were marked improvements in the International Index of Erectile Function score in the various groups. No major postoperative complications developed. In 4 patients wound healing occurred by secondary intent.
This technique provides excellent straightening of the curved penis. By avoiding isolation of the whole dorsal neurovascular bundle there is no risk of neurovascular lesions. Suture perception is minimized.
目前用于矫正先天性阴茎腹侧弯曲最广泛使用的技术仍然是最初由内斯比特描述的阴茎体成形术。我们展示了采用专门用于先天性阴茎腹侧弯曲的内斯比特阴茎体成形术变体治疗患者的结果。
从2000年6月至2007年6月,我们使用改良阴茎体成形术(中隔成形术)治疗了51例先天性阴茎腹侧弯曲患者,该手术包括进入阴茎背静脉床并从中切除1块或更多白膜菱形组织,呈楔形延伸至中隔4至5毫米深,直至阴茎完全伸直。评估患者病史、临床发现、自拍结果和国际勃起功能指数评分。弯曲程度用公式180度 - X表示,其中X代表阴茎轴的偏差度数。术前平均腹侧弯曲为131.4度(中位数135,范围145至110)。其中13例患者还存在勃起功能障碍。
术后随访时平均腹侧弯曲为178.3度(中位数179.1,范围180至175)。共有49人表示他们完全满意。阴茎缩短5至15毫米。与术前值相比,各组的国际勃起功能指数评分有显著改善。未发生重大术后并发症。4例患者伤口通过二期愈合。
该技术能使弯曲阴茎得到极佳的伸直效果。通过避免分离整个背侧神经血管束,不存在神经血管损伤风险。缝线感知降至最低。