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[阴茎海绵体旋转术治疗先天性阴茎弯曲的长期效果。]

[Long term results of congenital penile curvature treated with cavernosa corpora rotation.].

作者信息

Molina Escudero Roberto, Rodríguez Sánchez Lara, Herranz Yagüe José Antonio, Arnaiz Pérez Alberto Ramón, Álvarez Ardura Manuel, Páez Borda Álvaro

机构信息

Servicio de Urología. Hospital Universitario Fuenlabrada. Madrid. España.

出版信息

Arch Esp Urol. 2020 Mar;73(2):113-118.

Abstract

INTRODUCTION

Congenital penile curvature (PCC) is a disorder caused by an alteration in the embryonic development of the urethra and the corporacavernosa, which causes difficulty in penetration, requiring surgical correction when inter course is impossible.

OBJECTIVE

To analyze the results of the surgical treatment of the IPC by means of rotation of the corpora cavernosa (RCC) described and modified by Shaeer. PATIENTS AND METHODS: Ten patients diagnosed with PCC with impossibility to inter course, were operated in a period of 36 months. Prior to the intervention,we applied the IIEF-5 questionnaire, measured the length of the penis and the angle of curvature throughself-photographs in three projections. By subcoronal approach,we perform denudation of the penis. On both sides of the urethra we incised Buck's fascia and released the neurovascular bundle from the ventral to the dorsal side. We generate an artificial erection evidencing the curvature. On the dorsal aspect of both corpora cavernosa, we made two incisions in the external longitudinal layer of the tunica albuginea. We sutured the internal and external edges of both incisions together with a 4/0 non-reabsorbable monofilament continuous suture, checking the correction of the curvature by means of an artificial erection. The patients were discharged the day after the intervention. The penile length and curvature were determined in the sixth month, and the IIEF-5 questionnaire. For the comparison of means we used the Mann-Whitney U test.  RESULTS: The mean age was 26.8 years. The average follow-up was 20.7 months (12-31) and the median was 24. Before the intervention, the average curvature was 68.5° (50-90°); the average length 14.2 cm (10-18) and the IIEF-5 of 21. After surgery, the average length was 13.7 cm, the residual curvature the IIEF-5 of 25. There were no statistically significant differences between pre and postoperative penile length,(p=0.08). Nine patients assured that they would under go the same intervention again. CONCLUSIONS: RCC is an effective therapeutic alternative to the techniques of plication or lengthening of the tunica albuginea for the treatment of PCC, main tainingits long-term results.

摘要

引言

先天性阴茎弯曲(PCC)是一种由尿道和海绵体胚胎发育改变引起的疾病,导致性交困难,当无法进行性交时需要手术矫正。

目的

分析Shaeer描述并改良的通过海绵体旋转(RCC)治疗先天性阴茎弯曲的手术效果。

患者与方法

10例被诊断为先天性阴茎弯曲且无法进行性交的患者在36个月内接受了手术。在干预前,我们应用国际勃起功能指数-5(IIEF-5)问卷,通过阴茎在三个投影方向的自拍测量阴茎长度和弯曲角度。采用冠状下切口,对阴茎进行剥脱。在尿道两侧切开白膜的Buck筋膜,将神经血管束从腹侧松解至背侧。诱发人工勃起以明确弯曲情况。在两侧海绵体的背侧,在白膜的外纵层做两个切口。用4/0不可吸收单丝连续缝线将两个切口的内缘和外缘缝合在一起,通过人工勃起检查弯曲的矫正情况。患者在干预后的第二天出院。在第六个月测定阴茎长度和弯曲度,并再次进行IIEF-5问卷评估。为比较均值,我们使用了曼-惠特尼U检验。

结果

平均年龄为26.8岁。平均随访时间为20.7个月(12 - 31个月),中位数为24个月。干预前,平均弯曲度为68.5°(50 - 90°);平均长度为14.2厘米(10 - 18厘米),IIEF-5评分为21分。术后,平均长度为13.7厘米,残余弯曲度时IIEF-5评分为25分。术前和术后阴茎长度之间无统计学显著差异(p = 0.0

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