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急性阶段佩罗尼氏病的牵引器治疗:一项与超声相关性的非随机前瞻性对照试验。

Acute phase Peyronie's disease management with traction device: a nonrandomized prospective controlled trial with ultrasound correlation.

机构信息

Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

J Sex Med. 2014 Feb;11(2):506-15. doi: 10.1111/jsm.12400. Epub 2013 Nov 22.

Abstract

INTRODUCTION

Outcome data of penile traction therapy (PTT) for the acute phase (AP) of Peyronie's disease (PD) have not been specifically studied.

AIM

The aim of this study was to assess the effectiveness of a penile extender device for the treatment of patients with AP of PD.

METHODS

A total of 55 patients underwent PTT for 6 months and were compared with 41 patients with AP of PD who did not receive active treatment ("no intervention group" [NIG]).

MAIN OUTCOMES MEASURES

Pre- and posttreatment variables included degree of curvature, penile length and girth, pain by 0-10 cm visual analog scale (VAS), erectile function (EF) domain of the International Index of Erectile Function questionnaire, Erection Hardness Scale, Sexual Encounter Profile 2 question, and penile sonographic evaluation (only patients in the intervention group).

RESULTS

The mean curvature decreased from 33° at baseline to 15° at 6 months and 13° at 9 months with a mean decrease 20° (P < 0.05) in the PTT group. VAS score for pain decreased from 5.5 to 2.5 after 6 months (P < 0.05). EF and erection hardness also improved significantly. The percentage of patients who were not able to achieve penetration decreased from 62% to 20% (P < 0.03). In the NIG, deformity increased significantly, stretched flaccid penile length decreased, VAS score for pain increased, and EF and erection hardness worsened. PTT was associated with the disappearance of sonographic plaques in 48% of patients. Furthermore, the need for surgery was reduced in 40% of patients who would otherwise have been candidates for surgery and simplified the complexity of the surgical procedure (from grafting to plication) in one out of every three patients.

CONCLUSIONS

PTT seems an effective treatment for the AP of PD in terms of pain reduction, penile curvature decrease, and improvement in sexual function.

摘要

简介

阴茎牵引疗法(PTT)治疗 Peyronie 病(PD)急性期(AP)的结果数据尚未专门研究过。

目的

本研究旨在评估阴茎伸展器治疗 AP PD 患者的疗效。

方法

共有 55 例患者接受了 6 个月的 PTT,并与 41 例未接受主动治疗的 AP PD 患者(“无干预组”[NIG])进行了比较。

主要观察指标

治疗前后的变量包括弯曲度、阴茎长度和周长、0-10cm 视觉模拟评分(VAS)疼痛、国际勃起功能指数问卷的勃起功能(EF)域、勃起硬度评分、性遭遇剖面图 2 问题,以及阴茎超声评估(仅干预组患者)。

结果

平均曲率从基线时的 33°下降到 6 个月时的 15°和 9 个月时的 13°,PTT 组平均下降 20°(P <0.05)。疼痛的 VAS 评分从 6 个月时的 5.5 下降到 2.5(P <0.05)。EF 和勃起硬度也显著改善。无法完成性交的患者比例从 62%下降到 20%(P <0.03)。在 NIG 中,畸形明显加重,松弛的阴茎长度缩短,疼痛的 VAS 评分增加,EF 和勃起硬度恶化。PTT 与 48%患者的超声斑块消失有关。此外,40%原本需要手术的患者避免了手术,并且简化了三分之一患者的手术复杂性(从移植到修补)。

结论

PTT 似乎是治疗 PD 急性发作的有效方法,可减轻疼痛、降低阴茎弯曲度、改善性功能。

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