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一种基于白膜分层结构的新型阴茎成形术治疗先天性阴茎弯曲——长期疗效

A new corporoplasty based on stratified structure of tunica albuginea for the treatment of congenital penile curvature - long-term results.

作者信息

Perdzyński Wojciech, Adamek Marek

机构信息

Centre for Reconstructive Surgery of the Male Genito-Urinary Tract, Damian's Hospital, Warsaw, Poland.

出版信息

Cent European J Urol. 2015;68(1):102-8. doi: 10.5173/ceju.2015.01.496. Epub 2015 Mar 13.

Abstract

INTRODUCTION

The aim of the study was to report long-term results of treatment of patients with congenital penile curvature (CPC) with a new corporoplasty based on stratified structure of tunica albuginea, in which corporal bodies are not opened.

MATERIAL AND METHODS

From October 2006 to September 2013, the authors operated on 111 adult men with CPC. Ventral curvature was detected in 65 patients, lateral in 34, and dorsal in 12. Skin was incised longitudinally on convex surface of curvature. In ventral curvature, dorsal neuro-vascular bundles (NVBs) were separated from tunica albuginea and elliptical fragments of external (longitudinal) layer of tunica were excised. The tunica was sutured with absorbable sutures, which invaginated the internal (transversal) layer of tunica. In dorsal curvature, excisions were performed on both sides of the urethra, in lateral curvature - on the convex penile surface.

RESULTS

Follow-up period was from 12 to 84 months. The penis was completely straight in 109 out of 111 patients. In 2 patients (1.8%) recurrent curvature of up to 20 degrees was detected. Redo surgery was done in one individual (0.9%) at patient's request. Glandular sensation loss or erectile dysfunction was not detected in any patient during the period of observation.

CONCLUSIONS

A new operation for correction of CPC, which consists of excision of an elliptical fragment of the external layer of the tunica albuginea and plication of the internal layer gives good short and long-term results. Surgery done without penetrating the corpora cavernosa is minimally invasive, which diminishes the potential risk of complications, especially intra- and postoperative bleeding.

摘要

引言

本研究的目的是报告一种基于白膜分层结构的新型阴茎成形术治疗先天性阴茎弯曲(CPC)患者的长期结果,该手术不切开阴茎海绵体。

材料与方法

2006年10月至2013年9月,作者对111例成年CPC男性患者进行了手术。65例患者为腹侧弯曲,34例为外侧弯曲,12例为背侧弯曲。在弯曲的凸面纵向切开皮肤。对于腹侧弯曲,将背侧神经血管束(NVBs)与白膜分离,并切除白膜外层(纵向)的椭圆形碎片。用可吸收缝线缝合白膜,使白膜内层内陷。对于背侧弯曲,在尿道两侧进行切除;对于外侧弯曲,在阴茎凸面进行切除。

结果

随访期为12至84个月。111例患者中有109例阴茎完全伸直。2例患者(1.8%)检测到复发弯曲达20度。应患者要求,1例患者(0.9%)进行了再次手术。在观察期间,未在任何患者中检测到龟头感觉丧失或勃起功能障碍。

结论

一种矫正CPC的新手术,包括切除白膜外层的椭圆形碎片和折叠内层,可取得良好的短期和长期效果。不穿透阴茎海绵体进行手术具有微创性,可降低并发症的潜在风险,尤其是术中及术后出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f14c/4408394/f4493d0b2f0e/CEJU-68-00496-g001.jpg

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