Department of Urology and Andrology, Robert Debré Academic Hospital, Avenue du Général Koenig, Reims, France.
Int J Impot Res. 2010 Nov-Dec;22(6):343-8. doi: 10.1038/ijir.2010.28. Epub 2010 Dec 2.
The best surgical option for the management of severe cases of Peyronie's disease is currently a matter of debate. To determine medium-term outcomes and complications after treatment of severe Peyronie's disease by porcine small intestinal submucosa (SIS) grafts, we retrospectively reviewed 33 consecutive plaque incisions followed by 4-ply SIS grafting in 28 patients (2002-2009). Postoperative complications, penile length preservation, de novo ED, penile curvature correction and curvature recurrence rates were recorded. Median patient age was 54 years (38-69 years). Median preoperative curvature was 90° (30-90°) (stable for at least 6 months). Six patients (21%) had preoperative ED. There were few postoperative complications (no cases of infection, haematoma (n=2), penile hypoesthesia (n=1), patch rejection and migration (n=1)). Subjective penile shortening and de novo ED were observed in 7 (25%) and 3 (11%) patients, respectively. The success rate for the procedure (straight penis or curvature ≤20° and ability to have intercourse) was 67% (22/33). Four patients achieved curvature correction after a repeat procedure with a new SIS graft. Eleven patients experienced recurrence within 3 months of surgery. After a median follow-up of 9 months (3-94), 22 patients (79%) had a satisfactory curvature correction.
目前，对于严重 Peyronie 病的治疗，最佳手术选择仍存在争议。为了确定猪小肠黏膜下层（SIS）移植物治疗严重 Peyronie 病的中期结果和并发症，我们回顾性分析了 28 例（2002-2009 年）连续 33 例斑块切开术后 4 层 SIS 移植的患者。记录了术后并发症、阴茎长度保留、新发勃起功能障碍（ED）、阴茎弯曲矫正和弯曲复发率。中位患者年龄为 54 岁（38-69 岁）。中位术前弯曲度为 90°（30-90°）（至少稳定 6 个月）。6 例（21%）患者术前存在 ED。术后并发症较少（无感染病例，血肿 2 例，阴茎感觉减退 1 例，补片排斥和移位 1 例）。7 例（25%）患者出现主观阴茎缩短，3 例（11%）患者新发 ED。该手术的成功率（直阴茎或弯曲度≤20°且能够进行性交）为 67%（22/33）。4 例患者在再次使用新的 SIS 移植物后矫正了弯曲度。11 例患者在术后 3 个月内出现复发。中位随访 9 个月（3-94 个月）后，22 例（79%）患者的弯曲度矫正满意。
