Osterberg E C, Maganty A, Ramasamy R, Eid J F
Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
Weill Cornell Medical College, New York, NY, USA.
Int J Impot Res. 2014 Jul-Aug;26(4):128-31. doi: 10.1038/ijir.2013.50. Epub 2014 Jan 16.
Inflatable penile prosthesis (IPP) remains the gold standard for the surgical treatment of refractory erectile dysfunction; however, current literature to aid surgeons on how best to counsel patients on their postoperative inflated penile length is lacking. The aim of this study was to identify preoperative parameters that could better predict postoperative penile length following insertion of an IPP. Twenty men were enrolled in a prospective study examining penile lengths before and after IPP surgery. Patients with Peyronie's disease were excluded from this analysis. Baseline preoperative characteristics, including body mass index, history of hypertension, diabetes, Sexual Health Inventory for Men scores and/or prior radical prostatectomy were recorded. All patients underwent implantation with a three-piece inflatable Coloplast penile prosthesis. We compared stretched penile length to pharmacologically induced erect lengths. Postoperatively, we measured inflated penile lengths at 6 weeks and assessed patients' perception of penile size at 12 weeks. The median (±interquartile range) stretched penile length and pharmacologically induced erect penile length was 15 (±3) and 14.25 (±2) cm, respectively (P=0.5). Median post-prosthesis penile length (13.5±2.13 cm) was smaller than preoperative pharmacologically induced length (P=0.02) and preoperative stretched penile length (P=0.01). The majority of patients (70%) had a decrease in penile length (median loss 0.5±1.5 cm); however, this loss was perceptible by 43% of men. Stretched penile length and pharmacologically induced erect penile length were equally good predictors of postoperative inflated length (Spearman's correlation 0.8 and 0.9, respectively). Pharmacologically induced erect penile length and stretched penile lengths are equal predictors of post-prosthesis penile length. The majority of men will experience some decrease in penile length following prosthesis implantation; however <50% report a subjective loss of penile length.
可膨胀阴茎假体（IPP）仍然是难治性勃起功能障碍外科治疗的金标准；然而，目前缺乏帮助外科医生就术后阴茎膨胀长度向患者提供最佳咨询建议的文献。本研究的目的是确定能够更好预测IPP植入术后阴茎长度的术前参数。20名男性参与了一项前瞻性研究，该研究对IPP手术前后的阴茎长度进行了检查。患有佩罗尼氏病的患者被排除在本分析之外。记录了基线术前特征，包括体重指数、高血压病史、糖尿病史、男性性健康量表评分和/或既往根治性前列腺切除术。所有患者均接受了三件式可膨胀科洛普斯阴茎假体植入。我们将拉伸阴茎长度与药物诱导勃起长度进行了比较。术后，我们在6周时测量了阴茎膨胀长度，并在12周时评估了患者对阴茎大小的感知。拉伸阴茎长度和药物诱导勃起阴茎长度的中位数（±四分位间距）分别为15（±3）厘米和14.25（±2）厘米（P = 0.5）。假体植入后阴茎长度的中位数（13.5±2.13厘米）小于术前药物诱导长度（P = 0.02）和术前拉伸阴茎长度（P = 0.01）。大多数患者（70%）阴茎长度有所缩短（中位数缩短0.5±1.5厘米）；然而，43%的男性能够察觉到这种缩短。拉伸阴茎长度和药物诱导勃起阴茎长度对术后阴茎膨胀长度的预测效果同样良好（斯皮尔曼相关性分别为0.8和0.9）。药物诱导勃起阴茎长度和拉伸阴茎长度对假体植入后阴茎长度的预测效果相同。大多数男性在假体植入后阴茎长度会有所缩短；然而，报告主观感觉阴茎长度缩短的患者不到50%。
