Division of Urology, Department of Surgery, University of Texas Health Science Center, McGovern Medical School at Houston, Houston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Division of Urology, Department of Surgery, University of Texas Health Science Center, McGovern Medical School at Houston, Houston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Sex Med Rev. 2019 Jan;7(1):156-166. doi: 10.1016/j.sxmr.2018.07.001. Epub 2018 Oct 6.
Peyronie's disease (PD) is associated with penile length loss due to atrophy that occurs as a result of fibrous inelastic scarring. Studies have shown diminished penile length and girth, as well as the inability to participate in sexual activity, can lead to decreased quality of life, emotional challenges, and sexual dissatisfaction in a large percentage of men.
To provide a summary of the new developments in the surgical techniques available for the PD patient, with a focus on procedures that provide penile size restoration.
A MEDLINE PubMed search was used to identify articles related to surgical treatments for PD, including plication procedures, penile prosthesis placement, and techniques for size restoration.
Types of surgical treatments for PD and their outcomes regarding penile length and patient satisfaction.
The Nesbit procedure, among other plication procedures, and penile prosthesis placement with modeling or plication are likely to decrease penile length. Although plaque incision with grafting offers restoration of penile length, it carries a risk of postoperative erectile dysfunction (ED). For men with concomitant ED and severe curvature not amenable to prosthesis with modeling or plication, options include grafting, circumferential tunical incisions, subcoronal prosthesis placement, and the sliding technique with its modifications, allowing for management of both PD and ED while restoring penile length. Adjunct procedures, such as ventral phalloplasty and suspensory ligament release, have also been shown to restore length in PD patients. Novel therapies continue to evolve with the goal of preserving length while treating curvature.
There are numerous surgical options for correcting penile curvature in PD patients, with or without concomitant ED treatment. When determining the optimal procedure, it is important to consider possible preservation of penile length and to discuss possible complications to increase patient satisfaction and improve quality of life. Barrett-Harlow B, Clavell-Hernandez J, Wang R. New Developments in Surgical Treatment for Penile Size Preservation in Peyronie's Disease. Sex Med Rev 2019;7:156-166.
阴茎硬结症（PD）会导致阴茎萎缩，从而导致阴茎长度损失，这是由于纤维性非弹性瘢痕形成所致。研究表明，相当大比例的男性会出现阴茎长度和周长减小，以及无法参与性行为的情况，从而导致生活质量下降、情绪挑战和性不满。
总结 PD 患者可用的手术技术新进展，重点关注提供阴茎尺寸恢复的手术程序。
使用 MEDLINE PubMed 搜索来确定与 PD 手术治疗相关的文章，包括折叠程序、阴茎假体植入和尺寸恢复技术。
PD 的手术治疗类型及其对阴茎长度和患者满意度的影响。
除其他折叠程序外，Nesbit 手术和假体植入加整形或折叠术可能会缩短阴茎长度。虽然带蒂移植的斑块切开术可以恢复阴茎长度，但会增加术后勃起功能障碍（ED）的风险。对于同时患有 ED 和严重弯曲且不适合整形或折叠假体的患者，可选择包括移植、环周带蒂切开、冠状沟下假体放置和改良的滑动技术，这些技术允许在恢复阴茎长度的同时治疗 PD 和 ED。辅助程序，如腹侧阴茎成形术和悬韧带松解术，也已显示可恢复 PD 患者的长度。新的治疗方法不断发展，其目标是在治疗弯曲的同时保留长度。
对于 PD 患者，有许多手术选择可以纠正阴茎弯曲，无论是否同时治疗 ED。在确定最佳手术方案时，重要的是要考虑到可能保留阴茎长度，并讨论可能出现的并发症，以提高患者满意度并改善生活质量。
