Diao Linley, Anaissie James, Nguyen Hoang Minh Tue, Yafi Faysal A, Haney Nora M, DeLay Kenneth J, Peak Taylor C, Sikka Suresh C, Hellstrom Wayne J G
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Transl Androl Urol. 2017 Oct;6(5):894-898. doi: 10.21037/tau.2017.07.27.
To examine the changes in penile vascular parameters after the administration of collagenase Clostridium histolyticum (CCH) in patients with Peyronie's disease (PD).
We retrospectively reviewed the records for all patients treated with CCH for PD between 04/2014 and 05/2017 who underwent penile duplex Doppler ultrasound (PDDU) after pharmacologically induced erection both before and after four cycles of CCH treatment. The primary outcomes measured were changes in peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) after CCH treatment. Paired -tests, chi-squared tests, and correlation coefficients were performed between functional and vascular parameters before and after four rounds of CCH to determine statistical significance (P<0.05).
A total of 51 patients were included in the study. After four cycles of CCH therapy, there was no statistically significant change in PSV, EDV, RI, or International Index of Erectile Function score when compared to baseline. Similarly, there was no correlation between vascular parameters and change in curvature. There was a statistically significant change in penile curvature (60˚±16.9˚ to 40.8˚±14.9˚, P<0.001) and erect penile circumference (11.6±1.0 to 11.9±1.0 cm, P<0.05) after treatment.
In spite of a significant change in penile curvature, this change did not correlate with changing penile vascular or morphological parameters. Overall, CCH therapy seems to have a negligible impact on penile vasculature, furthering evidence of its favorable safety profile.
研究注射溶组织梭状芽孢杆菌胶原酶(CCH)后佩罗尼氏病(PD)患者阴茎血管参数的变化。
我们回顾性分析了2014年4月至2017年5月间接受CCH治疗的所有PD患者的记录,这些患者在CCH治疗的四个周期前后均接受了药物诱导勃起后的阴茎双功能多普勒超声(PDDU)检查。主要测量指标为CCH治疗后收缩期峰值流速(PSV)、舒张末期流速(EDV)和阻力指数(RI)的变化。在四轮CCH治疗前后,对功能和血管参数进行配对检验、卡方检验和相关系数分析,以确定统计学意义(P<0.05)。
共有51例患者纳入研究。与基线相比,CCH治疗四个周期后,PSV、EDV、RI或国际勃起功能指数评分无统计学显著变化。同样,血管参数与曲率变化之间也无相关性。治疗后阴茎曲率(60˚±16.9˚至40.8˚±14.9˚,P<0.001)和勃起阴茎周长(11.6±1.0至11.9±1.0 cm,P<0.05)有统计学显著变化。
尽管阴茎曲率有显著变化,但这种变化与阴茎血管或形态参数的改变无关。总体而言,CCH治疗似乎对阴茎血管系统影响可忽略不计,进一步证明了其良好的安全性。