Rice Patrick G, Somani Bhaskar K, Rees Rowland W
Urology Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
Urology Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
Sex Med. 2019 Jun;7(2):115-128. doi: 10.1016/j.esxm.2019.01.001. Epub 2019 Mar 16.
Plaque incision and grafting (PIG) is indicated for men with complex or severe penile curvature and, despite a multitude of incision types and grafting materials having been used, no individual technique has proven superiority.
To assess outcomes following PIG and to understand the operative technique.
A systematic review was performed to find all relevant studies reporting on use of the PIG technique to correct curvature resulting from Peyronie's disease. Studies were included if they had >40 participants, were written in the English language, and no penile prosthesis was implanted.
Primary outcome measures included deformity correction, erectile dysfunction, and degree of penile lengthening/shortening. Secondary outcome measures included satisfaction, reoperation rate, and complications.
Twelve studies were included in the quantitative synthesis, which overall report on the results of 1,025 patients. Careful patient selection was critical, with erectile function requiring assessment with the International Index of Erectile Function (IIEF), subjective patient reports, and consideration of whether erections are pharmacologically aided. There was no evidence of superiority in favor of any particular incision type or grafting material, and absorbable sutures were clearly favored. Postoperatively, 4.6%-67.4% required pharmacologically aided erections and 0-11.8% were completely unable to achieve erections. Successful straightening occurred in 80.0%-96.4%, although there was no consistent definition of success. Penile length was unchanged in 44.2%-95.0%; 88.0%-92.0% of the patients were satisfied, and .7%-4.7% required reoperation. Altered sensation occurred in 2.0%-22.5% of patients, of which 80.0%-100.0% was only a transient loss. All outcomes were heterogeneously reported. There are no clear predictive factors for erectile dysfunction following PIG surgery. No single incision type or grafting material has proven superiority.
PIG is an effective and safe technique for correction of complex or severe penile curvature in terms of satisfaction, length change, straightening, and complications. Rice PG, Somani BK, Rees RW. Twenty Years of Plaque Incision and Grafting for Peyronie's Disease: A Review of Literature. Sex Med 2019;7:115-128.
斑块切开与移植术（PIG）适用于患有复杂或严重阴茎弯曲的男性，尽管已经使用了多种切开类型和移植材料，但尚无任何一种单独的技术被证明具有优越性。
评估PIG术后的效果并了解手术技术。
进行了一项系统评价，以查找所有报告使用PIG技术矫正佩罗尼氏病所致弯曲的相关研究。纳入标准为研究对象超过40例、用英文撰写且未植入阴茎假体的研究。
主要观察指标包括畸形矫正、勃起功能障碍以及阴茎延长/缩短程度。次要观察指标包括满意度、再次手术率和并发症。
定量分析纳入了12项研究，这些研究总共报告了1025例患者的结果。仔细选择患者至关重要，勃起功能需要通过国际勃起功能指数（IIEF）、患者主观报告进行评估，并考虑勃起是否需要药物辅助。没有证据表明任何一种特定的切开类型或移植材料具有优越性，可吸收缝线明显更受青睐。术后，4.6%-67.4%的患者需要药物辅助勃起，0-11.8%的患者完全无法勃起。80.0%-96.4%的患者成功矫正了阴茎弯曲，尽管对于成功并没有一致的定义。44.2%-95.0%的患者阴茎长度未改变；88.0%-92.0%的患者感到满意，0.7%-4.7%的患者需要再次手术。2.0%-22.5%的患者出现感觉改变，其中80.0%-100.0%只是短暂性丧失。所有结果的报告均存在异质性。PIG手术后勃起功能障碍尚无明确的预测因素。没有一种切开类型或移植材料被证明具有优越性。
就满意度、长度变化、矫正效果和并发症而言，PIG是矫正复杂或严重阴茎弯曲的一种有效且安全的技术。赖斯PG，索马尼BK，里斯RW。佩罗尼氏病斑块切开与移植术20年：文献综述。性医学2019；7：115-128。
