Salem Emad A, Elkady Ehab H, Sakr Ahmed, Maarouf Aref M, Bendary Lotfy, Khalil Salem, Shahin Ashraf, Kamel Hussein
Department of Urology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Urology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Urology. 2014 Dec;84(6):1374-7. doi: 10.1016/j.urology.2014.07.042. Epub 2014 Oct 3.
To evaluate the use of lingual mucosal graft (LMG) as a substitute for tunica albuginea in the treatment of Peyronie disease (PD).
Seventeen patients, reporting normal erectile function, with PD interfering with sexual function were operated on by plaque excision and grafting with LMG. Preoperative assessment included: the International Index of Erectile Function-5 score, penile duplex, and penile curvature angle measurement. Postoperative erectile function and penile deformity were assessed every 3 months for 9-18 months.
Mean age of the patients was 52 (± 4.7) years and mean angle of deformity was 60° (± 5.1). Donor site complications occurred in the form of mild transient swelling, numbness, and pain. Postoperative assessment showed complete penile straightening in 15 patients with mild curvature recurrence (<20°) in 2 patients at the third month. De novo mild erectile dysfunction was reported by 1 patient who responded to low-dose phosphodiesterase type 5 inhibitor. Patients' and partners' satisfaction was reported in 16 (94%) patients. These results remained stable until the end of the follow-up period.
LMG seems to be a valuable substitute for tunica albuginea in cases of PD. It is readily available and shows early graft take. It also proved safety, reliability, feasibility, and a satisfactory short-term outcome for the treatment of PD.
评估使用舌黏膜移植物(LMG)替代白膜治疗佩罗尼氏病(PD)的效果。
17例勃起功能正常但PD影响性功能的患者接受了斑块切除及LMG移植手术。术前评估包括:国际勃起功能指数-5评分、阴茎双功能超声以及阴茎弯曲角度测量。术后每3个月评估勃起功能和阴茎畸形情况,为期9至18个月。
患者平均年龄为52(±4.7)岁,平均畸形角度为60°(±5.1)。供区并发症表现为轻度短暂肿胀、麻木和疼痛。术后评估显示,15例患者阴茎完全伸直,2例患者在第三个月出现轻度弯曲复发(<20°)。1例患者出现新发轻度勃起功能障碍,对低剂量5型磷酸二酯酶抑制剂有反应。16例(94%)患者报告了患者及其伴侣的满意度。直至随访期结束,这些结果保持稳定。
在PD病例中,LMG似乎是白膜的一种有价值的替代物。它易于获取且早期移植成活良好。它还证明了在治疗PD方面的安全性、可靠性、可行性以及令人满意的短期效果。