Department of Urology, University of California, San Francisco, CA, USA.
BJU Int. 2011 Feb;107(4):622-5. doi: 10.1111/j.1464-410X.2010.09546.x. Epub 2010 Aug 26.
Ossified Peyronie's plaques may require surgical excision because of the palpable problems and penile curvature that result. As tunical excision can result in impotence and decrease penile sensation, we describe a novel method of tunical preserving excision of such lesions.
We evaluated 12 men with dorsal penile curvature between 10° and 90°. Penile plaque size ranged from 1 to 5 cm. 80% had painful erections. An artificial erection was induced with intracavernous injection of papaverine to assess penile deformity. Via a circumcising or ventral incision, plication sutures were placed to correct penile curvature. A lateral longitudinal corporotomy was made and the calcified/ossified portion was dissected free from the tunica albuginea/plaque of the corpora cavernosa. Watertight tunical closure was then performed.
Postoperatively, 80% of men reported erections always adequate for intercourse and normal sensation with a mean follow-up of 7 months (range 2.1-14.5 months). All patients required simultaneous penile plication to ensure a straight phallus. Pathologic evaluation of plaque specimens all showed bone fragments.
Tunica-sparing excision of the ossified/calcified portion of Peyronie's plaques shows a durable benefit for large, ossified lesions and maintains potency and penile sensation.
由于触诊时存在问题和阴茎弯曲，导致骨化的 Peyronie 斑块可能需要手术切除。由于白膜切除术可能导致勃起功能障碍和阴茎感觉减退，因此我们描述了一种保留白膜的此类病变切除术的新方法。
我们评估了 12 名阴茎背部弯曲角度在 10°至 90°之间的男性。阴茎斑块大小从 1 厘米到 5 厘米不等。80%的患者有勃起疼痛。通过阴茎海绵体内注射罂粟碱诱导人工勃起，以评估阴茎变形。通过环形或腹侧切口，放置折叠缝线以矫正阴茎弯曲。进行横向纵向 corporotomy，将钙化/骨化部分从阴茎白膜/海绵体斑块中游离出来。然后进行严密的白膜闭合。
术后，80%的患者报告勃起始终足以进行性交，并且感觉正常，平均随访 7 个月（范围 2.1-14.5 个月）。所有患者均需要同时进行阴茎折叠以确保笔直的阴茎。斑块标本的病理评估均显示骨碎片。
保留白膜的 Peyronie 斑块的骨化/钙化部分切除术对大的骨化病变具有持久的益处，并保持勃起功能和阴茎感觉。
