Department of Urology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
BJU Int. 2010 Sep;106(5):691-4. doi: 10.1111/j.1464-410X.2009.09194.x.
To compare the durability and complication rates of surgery to implant an inflatable penile prosthesis (IPP) between patients with and without Peyronie's disease (PD).
We retrospectively reviewed all patients undergoing IPP surgery at one centre (Memphis) between July 1997 and May 2007. Variables included age at surgery, race, body mass index, presence of PD, brand/type of IPP (two vs three pieces), presence of diabetes mellitus (DM), active tobacco use, and complications. The result were assessed using t-tests, chi-square and regression analysis, with P < 0.05 considered to indicate significant differences.
In all, 79 men were analysed (mean age 59.8 years, range 38.1-81.5). Nine (11%) patients had PD and had a IPP implanted, with penile modelling. Overall, 43 (54%) patients had pre-existing DM and 51 (65%) actively used tobacco. At a mean (range) follow-up of 19.6 (0.1-115.3) months, six (8%) patients had component malfunctions. Of these, three had DM and four actively smoked. Of the nine patients with PD, three developed component malfunctions, vs three (4%) who did not have PD (P= 0.002). Both groups had similar infection rates (P= 0.98). The mean (range) time to component malfunction was 4.3 (0.1-9.6) months, which was longer (but not significantly) in the PD group, with a mean (median, range) of 10.9 (6.3, 1.1-9.6) months, than the 3.0 (1.0, 0.2-7.9) months in the group without PD (P= 0.4). Groups were matched for rates of DM (P= 0.1) and tobacco use (P= 0.2). PD was a significant predictor of component malfunction on both univariate (P= 0.001) and multivariate analysis (P= 0.002) when adjusting for age (P= 0.2), body mass index (P= 0.7), DM (P= 0.3) and tobacco use (P= 0.8).
Patients with PD implanted with a IPP, with penile modelling, had significantly higher component malfunction rates. Further, PD independently predicted component malfunction. These findings might be related to stress on the device at the time of surgery, during use, or both. Further study into this relationship is required.
比较有和没有 Peyronie 病（PD）的患者接受可膨胀阴茎假体（IPP）植入手术的耐用性和并发症发生率。
我们回顾性分析了 1997 年 7 月至 2007 年 5 月在一个中心（孟菲斯）接受 IPP 手术的所有患者。变量包括手术时的年龄、种族、体重指数、PD 存在情况、IPP 品牌/类型（两件式与三件式）、糖尿病（DM）、主动吸烟的存在情况和并发症。使用 t 检验、卡方检验和回归分析进行结果评估，P＜0.05 表示差异有统计学意义。
共有 79 名男性接受了分析（平均年龄 59.8 岁，范围 38.1-81.5）。9 名（11%）患者患有 PD 并接受了 IPP 植入和阴茎成型术。总体而言，43 名（54%）患者有既往 DM，51 名（65%）患者有主动吸烟。在平均（范围）19.6（0.1-115.3）个月的随访中，有 6 名（8%）患者出现了组件故障。其中，3 名患有 DM，4 名主动吸烟。在 9 名 PD 患者中，有 3 名出现了组件故障，而没有 PD 的患者中有 3 名（4%）（P=0.002）。两组感染率相似（P=0.98）。组件故障的平均（范围）时间为 4.3（0.1-9.6）个月，PD 组的时间略长（但无统计学意义），平均（中位数，范围）为 10.9（6.3，1.1-9.6）个月，而无 PD 组为 3.0（1.0，0.2-7.9）个月（P=0.4）。两组 DM 发生率（P=0.1）和吸烟率（P=0.2）匹配。PD 在单变量（P=0.001）和多变量分析（P=0.002）中都是组件故障的显著预测因子，当调整年龄（P=0.2）、体重指数（P=0.7）、DM（P=0.3）和吸烟（P=0.8）时。
接受阴茎模型 IPP 植入的 PD 患者组件故障发生率明显更高。此外，PD 独立预测了组件故障。这些发现可能与手术时、使用时或两者同时对设备的压力有关。需要进一步研究这种关系。
