Tausch Timothy J, Chung Paul H, Siegel Jordan A, Gliga Louise, Klein Alexandra K, Morey Allen F
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Urology. 2015 Nov;86(5):1048-52. doi: 10.1016/j.urology.2015.06.042. Epub 2015 Jul 17.
To present a novel algorithm for definitive reconstruction of penile curvature in men undergoing inflatable penile prosthesis (IPP) surgery as an alternative to manual penile modeling and grafting procedures.
Patients with erectile dysfunction and concomitant penile curvature undergoing IPP placement were divided into 2 treatment groups: (1) group 1, penile deformity known preoperatively, and (2) group 2, penile curvature recognized intraoperatively after IPP placement. Group 1 patients underwent penile plication after artificial erection and immediately before IPP insertion via the same penoscrotal incision, whereas group 2 patients were treated with a Yachia (Heineke-Mikulicz) corporoplasty over the intact cylinders. Patients completed postoperative Patient Global Impression of Improvement (PGI-I) questionnaires assessing overall satisfaction.
Among 405 men receiving IPP at our institution from 2007 to 2014, 30 patients received synchronous correction of penile curvature (7%). Group 1 included 23 of 30 (77%) patients, and 7 of 30 (23%) were in group 2. Overall mean initial curvature was 36°, and all patients were corrected to < 10°. Average operative times were 18 minutes longer compared with patients who underwent IPP placement alone (82 vs 64 minutes, P <.05). At an average follow-up of 13 months (range 7-32), 19 of 20 (95%) group 1 and 6 of 7 (86%) group 2 patients who completed surveys reported an improved overall condition. No patient reported chronic pain, recurrent deformity, or device malfunction.
Penile curvature can be safely and reliably corrected at the time of IPP placement, regardless of whether the deformity was identified preoperatively.
提出一种用于接受可膨胀阴茎假体（IPP）手术的男性阴茎弯曲最终重建的新算法，作为手动阴茎塑形和移植手术的替代方法。
患有勃起功能障碍并伴有阴茎弯曲且接受IPP植入的患者被分为2个治疗组：（1）第1组，术前已知阴茎畸形；（2）第2组，IPP植入后术中发现阴茎弯曲。第1组患者在人工勃起后且即将通过相同的阴囊切口插入IPP之前进行阴茎折叠术，而第2组患者则在完整的圆柱体上进行亚奇亚（海涅克-米库利奇）阴茎成形术。患者完成术后患者总体改善印象（PGI-I）问卷以评估总体满意度。
2007年至2014年在我们机构接受IPP的405名男性中，30名患者接受了阴茎弯曲的同步矫正（7%）。第1组包括30名患者中的23名（77%），第2组包括30名中的7名（23%）。总体平均初始弯曲度为36°，所有患者均矫正至<10°。与仅接受IPP植入的患者相比，平均手术时间长18分钟（82分钟对64分钟，P<.05）。平均随访13个月（范围7 - 32个月），完成调查的20名第1组患者中的19名（95%）和7名第2组患者中的6名（86%）报告总体状况有所改善。没有患者报告慢性疼痛、复发性畸形或装置故障。
无论畸形是术前发现还是术中发现，在IPP植入时均可安全可靠地矫正阴茎弯曲。
