Kueronya Verena, Miernik Arkadius, Stupar Slavisa, Kojovic Vladimir, Hatzichristodoulou Georgios, Egydio Paulo H, Tosev Georgi, Falcone Marco, De Luca Francesco, Mulalic Demir, Djordjevic Miroslav, Schoenthaler Martin, Fahr Christian, Kuehhas Franklin E
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
BJU Int. 2015 May;115(5):822-8. doi: 10.1111/bju.12968.
To compare patient-reported outcomes (PROs) of surgical correction of Peyronie's disease (PD) with the Nesbit procedure, plaque incision and grafting, and the insertion of a malleable penile implant after surgical correction of penile curvature.
We performed a retrospective review of men who underwent surgical correction of PD between January 2010 and December 2012 at six international centres. Treatment-related PROs and satisfaction were evaluated with a non-validated questionnaire.
The response rate to the questionnaire was 70.9%, resulting in a study cohort of 206 patients. The Nesbit procedure, plaque incision with grafting, or implantation of a malleable penile prosthesis was performed in 50, 48, and 108 patients, respectively. Overall, 79.1% reported a subjective loss of penile length due to PD preoperatively (range 2.1-3.2 cm). Those patients treated with a malleable penile implant reported the greatest subjective penile length loss, due to PD. A subjective loss of penile length of >2.5 cm resulted in reduced preoperative sex ability. Postoperatively, 78.0%, 29.2% and 24.1% patients in the Nesbit, grafting, and implant groups reported a postoperative, subjective loss of penile length (range 0.4-1.2 cm), with 86.3%, 78.6%, and 82.1% of the patients in each group, respectively, being bothered by the loss of length.
Penile length loss due to PD affects most patients. Further penile length loss due to the surgical correction leads to bother among the affected patients, irrespective of the magnitude of the loss. The Nesbit procedure was associated with the highest losses in penile length. In patients with PD and severe erectile dysfunction, a concomitant lengthening procedure may be offered to patients to help overcome the psychological burden caused by the loss of penile length.
比较佩罗尼氏病（PD）手术矫正采用内斯比特手术、斑块切开及移植术以及阴茎弯曲手术矫正后植入可弯曲阴茎假体患者报告结局（PROs）。
我们对2010年1月至2012年12月期间在六个国际中心接受PD手术矫正的男性患者进行了回顾性研究。使用一份未经验证的问卷评估与治疗相关的PROs及满意度。
问卷回复率为70.9%，形成了一个206例患者的研究队列。分别有50例、48例和108例患者接受了内斯比特手术、斑块切开加移植术或植入可弯曲阴茎假体。总体而言，79.1%的患者术前报告因PD导致主观阴茎长度缩短（范围为2.1 - 3.2厘米）。接受可弯曲阴茎假体治疗的患者报告因PD导致的主观阴茎长度缩短最为明显。主观阴茎长度缩短>2.5厘米导致术前性功能下降。术后，内斯比特组、移植组和假体植入组分别有78.0%、29.2%和24.1%的患者报告术后主观阴茎长度缩短（范围为0.4 - 1.2厘米），每组分别有86.3%、78.6%和82.1%的患者因长度缩短而感到困扰。
PD导致的阴茎长度缩短影响大多数患者。手术矫正导致的进一步阴茎长度缩短会使受影响患者感到困扰，无论缩短幅度大小。内斯比特手术导致的阴茎长度损失最大。对于患有PD和严重勃起功能障碍的患者，可考虑同时进行延长手术，以帮助克服因阴茎长度缩短引起的心理负担。
