Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Sex Med. 2019 Mar;16(3):474-478. doi: 10.1016/j.jsxm.2019.01.012. Epub 2019 Feb 14.
Spontaneous penile tumescence after penile prosthesis implantation has been sporadically reported in the literature.
To preserve residual erectile function of patients' spontaneous penile tumescence by sparing cavernous tissue in the course of malleable penile prosthesis implantation.
Overall, 92 patients were randomized into 2 equal arms; patients undergoing conventional malleable penile prosthesis implantation, and patients undergoing the cavernous tissue-sparing technique. 1 month after surgery, these patients underwent penile duplex examination to assess the maximal cavernous tissue thickness around the implant cylinders. Additionally, they were asked about the occurrence of any spontaneous or arousal-induced penile tumescence.
Postoperative changes were compared with the preoperative ones.
The mean maximal cavernous tissue thickness was shown to be significantly higher in the cavernous tissue-sparing group compared with the conventional surgery group (5.2 ± 0.8 mm vs 2.2 ± 1.04 mm, P < .01). In the cavernous tissue-sparing group, 41 of 46 patients (89.13%) reported having a significantly higher incidence of residual penile tumescence vs 7 of 46 patients (15.2%) in the conventional surgery group (P < .001). The postoperative penile girth was significantly higher in the cavernous tissue-sparing group than in the conventional surgery group (11.16 ± 1.1 cm vs 10.11 ± 1.15 cm, P < .001).
This study provides a step-by-step approach to maintaining post-implantation penile tumescence and preserving penile girth in a reproducible manner.
STRENGTHS & LIMITATIONS: This is the first study to demonstrate the benefits of implanting a penile prosthesis while the penis is in a pharmacologically induced tumescent state. It is also the first to make use of ultrasound imaging in assessing postoperative corporal tissue. The main limitations are the short postoperative follow-up period and the non-blinding of measurements.
It could be concluded that the cavernous tissue-sparing technique is a reproducible technique that has the added value of preserving residual erectile function in the form of retained postoperative penile tumescence and preserved penile girth. Zaazaa A, Mostafa T. Spontaneous Penile Tumescence by Sparing Cavernous Tissue in the Course of Malleable Penile Prosthesis Implantation. J Sex Med 2019;16:474-478.
阴茎假体植入后自发性阴茎勃起在文献中偶有报道。
通过在可屈性阴茎假体植入过程中保留海绵体组织来保留患者自发性阴茎勃起的残余勃起功能。
共有 92 例患者被随机分为两组，一组接受常规可屈性阴茎假体植入，另一组接受海绵体组织保留技术。术后 1 个月，这些患者接受阴茎双功能超声检查，以评估植入圆柱体周围海绵体组织的最大厚度。此外，还询问了患者是否出现任何自发性或唤起性阴茎勃起。
比较术后与术前的变化。
海绵体组织保留组的最大海绵体组织厚度明显高于常规手术组（5.2 ± 0.8 mm 比 2.2 ± 1.04 mm，P<.01）。在海绵体组织保留组中，46 例患者中有 41 例（89.13%）报告说残余阴茎勃起的发生率显著高于常规手术组的 7 例（15.2%）（P<.001）。海绵体组织保留组的术后阴茎周径明显高于常规手术组（11.16 ± 1.1 cm 比 10.11 ± 1.15 cm，P<.001）。
本研究提供了一种逐步的方法来维持阴茎假体植入后的阴茎勃起，并以可重复的方式保留阴茎周径。
这是第一项证明在阴茎处于药物诱导勃起状态下植入阴茎假体的益处的研究，也是第一项利用超声成像评估术后 corpora 组织的研究。主要的局限性是术后随访时间短和测量结果非盲法。
可以得出结论，海绵体组织保留技术是一种可重复的技术，具有保留术后自发性阴茎勃起和保留阴茎周径的附加价值。
