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[佩罗尼氏病的斑块切开术及速即纱移植术]

[Plaque incision and Tachosil graft in Peyronie's Disease].

作者信息

de Sallmard G, Morel-Journel N, Sbizzera M, Hanquiez P, Ruffion A, Terrier J-E

机构信息

Service d'urologie, CHU de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.

Service d'urologie, CHU de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.

出版信息

Prog Urol. 2020 Feb;30(2):119-125. doi: 10.1016/j.purol.2019.11.011. Epub 2020 Feb 14.

Abstract

INTRODUCTION

Surgery is a treatment for correction of penile curvature in Peyronie's disease. Partial plaque excision and grafting is recommended for severe and complex curvature.

METHODS

Patients with stable penile curvature who underwent a partial plaque excision and grafting between January 2017 and April 2018 were retrospectively included. The graft was realized using a self-adhesive collagen fleece (Tachosil®). Penile curvature, penile length and erection score were measured before and after surgery.

RESULTS

Twenty-one patients, aged 52,13 (18-70 years) were included. The average follow-up after surgery was 8,36 months (1-14 months). Early complications included two hematomas and one dysuria (Clavien 1). One patient had a penile prosthesis hernia 3 months after surgery, and needed a new surgery (Clavien 3B). Patients stayed at the hospital 1.38 night (1-5) and operating time was 158min (102-249min). Average penile curvature after surgery was 5.88° (0-30°), while it was 82.75° (50-100°) before. Erection score increased from 7.62 (3-10) to 7.86 (4-10). There was no modification of the penile length 11.92cm (11-14.5) after surgery and 12.09cm (10-15cm) before.

CONCLUSION

The use of TachoSil® reduces the operative time, is easy to use and has hemostatic properties at a low cost. However, prospective randomized trial and long terms results are required to confirm our encouraging results.

LEVEL OF EVIDENCE

摘要

引言

手术是治疗佩罗尼氏病阴茎弯曲的一种方法。对于严重和复杂的弯曲,建议进行部分斑块切除和移植。

方法

回顾性纳入2017年1月至2018年4月间接受部分斑块切除和移植且阴茎弯曲稳定的患者。使用自粘性胶原绒(速即纱®)进行移植。在手术前后测量阴茎弯曲度、阴茎长度和勃起评分。

结果

纳入21例患者,年龄52.13岁(18 - 70岁)。术后平均随访8.36个月(1 - 14个月)。早期并发症包括2例血肿和1例排尿困难(Clavien 1级)。1例患者术后3个月发生阴茎假体疝,需要再次手术(Clavien 3B级)。患者住院1.38晚(1 - 5晚),手术时间为158分钟(102 - 249分钟)。术后平均阴茎弯曲度为5.88°(0 - 30°),术前为82.75°(50 - 100°)。勃起评分从7.62(3 - 10)增加到7.86(4 - 10)。术后阴茎长度为11.92cm(11 - 14.5cm),术前为12.09cm(10 - 15cm),无变化。

结论

使用速即纱®可缩短手术时间,易于使用且具有止血特性,成本低廉。然而,需要前瞻性随机试验和长期结果来证实我们令人鼓舞的结果。

证据水平

3级。

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