Department of Urology and Pediatric Urology, Julius Maximilians University of Würzburg, Würzburg, Germany.
Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
Sex Med Rev. 2017 Oct;5(4):544-552. doi: 10.1016/j.sxmr.2017.01.006. Epub 2017 Mar 1.
Peyronie's disease (PD) is a benign fibrotic disorder of the tunica albuginea of the penis, which can cause penile pain, curvature, shortening, erectile dysfunction, and psychological distress. Surgery is indicated when penile curvature prevents satisfactory sexual intercourse. Plaque incision or excision with grafting has been suggested as an option in patients with a penile curvature greater than 60°, a shortened penis, and/or an hourglass or complex deformity.
To provide an overview of recent studies reporting outcomes of grafting techniques and to report advances in the development of new grafting materials for PD surgery.
A literature review was performed through PubMed from 2011 through 2016 regarding grafting techniques for PD. Key words used for the search were grafting techniques, grafts, graft materials, Peyronie's disease, surgical outcomes, and surgical therapy.
To report on novel and promising graft materials for PD and to discuss surgical techniques, outcomes, and limitations. Discussed outcomes include postoperative penile straightening, shortening, erectile function, glans sensation, and patient satisfaction.
Various surgical techniques and grafting materials can be used for the coverage of the tunica albuginea defect after partial plaque excision or incision. Autologous and non-autologous grafts have been used in this setting. A major advantage of the available "off-the-shelf" grafts is that they do not require donor site harvesting, thus decreasing morbidity and operative time. Tissue-engineered grafts represent the future, but more research is needed to further improve surgical handling and postoperative outcomes.
Patients opting for grafting techniques should have sufficient erectile rigidity preoperatively. Surgeon experience, careful patient selection, patient preference, and type of penile deformity affect the choice of graft and surgical approach used. Hatzichristodoulou G, Osmonov D, Kübler H, et al. Contemporary Review of Grafting Techniques for the Surgical Treatment of Peyronie's Disease. Sex Med Rev 2017;5:544-552.
佩罗尼氏病（PD）是一种阴茎白膜的良性纤维性疾病，可导致阴茎疼痛、弯曲、缩短、勃起功能障碍和心理困扰。当阴茎弯曲导致满意的性交受到阻碍时，手术是必要的。当阴茎弯曲大于 60°、阴茎缩短和/或沙漏形或复杂畸形时，建议采用切开或切除斑块并用移植物进行治疗。
提供最近关于报告移植物技术结果的研究综述，并报告 PD 手术中新移植物材料的进展。
通过 PubMed 对 2011 年至 2016 年期间关于 PD 移植物技术的文献进行了回顾。用于搜索的关键词是移植物技术、移植物、移植物材料、佩罗尼氏病、手术结果和手术治疗。
报告 PD 的新型有前途的移植物材料，并讨论手术技术、结果和局限性。讨论的结果包括术后阴茎伸直、缩短、勃起功能、龟头感觉和患者满意度。
在部分斑块切除或切开后覆盖白膜缺陷，可以使用各种手术技术和移植物材料。自体和非自体移植物都已用于这种情况。现有“现成”移植物的一个主要优点是它们不需要供体部位采集，从而降低了发病率和手术时间。组织工程移植物代表了未来，但需要进一步的研究来进一步改善手术处理和术后结果。
选择移植物技术的患者术前应具有足够的勃起硬度。手术医生的经验、仔细的患者选择、患者的偏好和阴茎畸形的类型影响移植物的选择和使用的手术方法。
