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阴茎牵引疗法结合新型装置“Penimaster PRO”在稳定期的 Peyronie 病中有效且安全:一项对照多中心研究。

Penile traction therapy with the new device 'Penimaster PRO' is effective and safe in the stable phase of Peyronie's disease: a controlled multicentre study.

机构信息

Hospital Universitario Sanitas la Zarzuela, Madrid, Spain.

NU Hospitals, Bangalore, Karnataka, India.

出版信息

BJU Int. 2019 Apr;123(4):694-702. doi: 10.1111/bju.14602. Epub 2018 Nov 22.

Abstract

OBJECTIVES

To evaluate the efficacy and safety of a new penile traction device (PTD), 'Penimaster PRO', in a group of patients with stable Peyronie's disease (PD) compared with a non-intervention group in a multicentre study.

MATERIAL AND METHODS

A total of 93 patients with chronic stable PD (without erectile dysfunction, with no significant pain, and with a unidirectional curvature of at least 45° being stable for > 3 months) were recruited and followed for a 12-week period. Of these patients, 47 were randomly assigned to the Penimaster PRO group (PG) and 46 to the non-intervention group (NIG). Patients were asked to apply the PTD 3-8 h a day for 12 consecutive weeks, with specific instructions regarding the progressive increase of traction force applied to the penis over time. The primary outcome of the study was the change in the degree of curvature measured in the fully erect state after intracavernosal injection of alprostadil at baseline, 1, 2 and 3 months. Other variables, such as the type of curvature, stretched penile length (SPL), Peyronie's Disease Questionnaire (PDQ) scores, erectile function domain of the International Index of Erectile function (IIEF-EF) score and adverse events (AEs) were also assessed in each visit.

RESULTS

Forty-one patients in the PG and 39 in the NIG completed the study. There was an overall reduction in curvature of 31.2° (P < 0.001) at 12 weeks compared to baseline in the PG, representing a 41.1% improvement from baseline, which significantly correlated with the number of daily hours the device was applied in a dose-dependent manner. Those patients using the device < 4 h/day experienced a reduction of 15°-25° (mean 19.7°, 28.8% improvement; P < 0.05), while patients using the device > 6 h/day experienced greater curvature reduction, ranging from 20° to 50° (mean of 38.4°, 51.4% improvement; P < 0.001). In contrast, no significant changes in curvature were observed in the NIG. Furthermore, SPL increased significantly in the PG compared to baseline and compared with the NIG, ranging from 0.5 to 3.0 cm (mean 1.8 cm; P < 0.05). The IIEF-EF score also improved in patients in the PG (by a mean of 5 points). Mild AEs occurred in 43% of patients, such as local discomfort and glans numbness.

CONCLUSION

The use of the Penimaster PRO PTD, a non-invasive treatment, should be offered to patients with stable PD for 3 consecutive months before performing any corrective surgery, as this provided a significant reduction in the curvature, an increase in penile length and a significant improvement of the symptoms and bother induced by PD.

摘要

目的

评估一种新的阴茎牵引装置(PTD)“Penimaster PRO”在一组稳定型 Peyronie 病(PD)患者中的疗效和安全性,与非干预组进行比较,该研究为多中心研究。

材料和方法

共招募了 93 例慢性稳定型 PD(无勃起功能障碍,无明显疼痛,且单向弯曲度至少为 45°,稳定 3 个月以上)患者,并进行了 12 周的随访。这些患者中,47 例被随机分配到 Penimaster PRO 组(PG),46 例分到非干预组(NIG)。患者被要求每天使用 PTD 3-8 小时,连续 12 周,同时针对随时间推移逐渐增加阴茎牵引力给予具体的指导。研究的主要结局是在基线、1、2 和 3 个月时,经海绵体内注射前列地尔后在完全勃起状态下测量的弯曲度变化。其他变量,如弯曲类型、伸展阴茎长度(SPL)、Peyronie 病问卷(PDQ)评分、国际勃起功能指数(IIEF-EF)评分的勃起功能域和不良事件(AE)也在每次就诊时进行评估。

结果

PG 中有 41 例患者和 NIG 中有 39 例患者完成了研究。PG 组在 12 周时与基线相比,弯曲度总体减少了 31.2°(P < 0.001),这代表了 41.1%的基线改善,与每天使用装置的小时数呈剂量依赖性显著相关。每天使用装置<4 小时的患者弯曲度减少 15°-25°(平均 19.7°,改善 28.8%;P < 0.05),而每天使用装置>6 小时的患者弯曲度减少更多,范围为 20°-50°(平均 38.4°,改善 51.4%;P < 0.001)。相比之下,NIG 中没有观察到弯曲度的显著变化。此外,PG 中的 SPL 与基线相比以及与 NIG 相比均显著增加,范围为 0.5-3.0 cm(平均 1.8 cm;P < 0.05)。PG 中患者的 IIEF-EF 评分也有所改善(平均提高 5 分)。43%的患者出现轻度 AE,如局部不适和龟头麻木。

结论

对于稳定型 PD 患者,应在进行任何矫正手术前连续 3 个月使用 Penimaster PRO PTD 等非侵入性治疗方法,因为这可以显著降低弯曲度,增加阴茎长度,并显著改善 PD 引起的症状和困扰。

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