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多中心经验:使用胶原绒片进行斑块切开,并在置入可膨胀性阴茎假体时进行移植物矫正,以纠正 Peyronie 病患者的残余弯曲。

Multicenter Experience Using Collagen Fleece for Plaque Incision With Grafting to Correct Residual Curvature at the Time of Inflatable Penile Prosthesis Placement in Patients With Peyronie's Disease.

机构信息

Department of Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany.

Department of Urology, Mayo Clinic, Rochester, MN, USA.

出版信息

J Sex Med. 2020 Jun;17(6):1168-1174. doi: 10.1016/j.jsxm.2020.02.019. Epub 2020 Mar 18.

Abstract

BACKGROUND

Adjuvant maneuvers are often necessary to correct residual curvature during inflatable penile prosthesis (IPP) placement in patients with Peyronie's disease (PD).

AIM

We present our multicenter experience using collagen fleece as graft material for plaque incision and grafting (PIG) during IPP placement in patients with moderate to severe PD.

METHODS

We retrospectively reviewed 51 patients with IPP from 3 sites who underwent PIG with Tachosil (Baxter, IL) collagen fleece. Coloplast (Minneapolis, MN) IPP devices were used. Factors associated with residual curvature, revision, and patient satisfaction were performed using chi-squared analysis.

OUTCOMES

We evaluated postoperative outcomes including factors associated with residual curvature, revision, and patient satisfaction.

RESULTS

The mean compound curvature was 69.6°. The mean follow-up was 10.6 (range 1-38) months. All patients reported erections sufficient for penetrative intercourse at the last follow-up. Residual curvature <15° was noted in 6 of 51 (12%) patients. 3 patients required device revision. 2 patients experienced temporary glanular paresthesia, and no patients experienced device infection.

CLINICAL IMPLICATIONS

In our multicenter study, patients experienced substantial curve correction with minimal complications, and in the few patients who had persistent mild curvature, severe preoperative curvature (>60°) was found to be the only risk factor.

STRENGTHS & LIMITATIONS: Our study represents the largest series of patients coming from multiple centers undergoing surgical correction of PD with IPP and collagen fleece grafting. Limitations of this study include the retrospective study design, lack of a comparison group, and modest follow-up.

CONCLUSION

PIG using collagen fleece is a safe and effective means of correcting residual curvature after IPP placement in patients with moderate to severe PD. Hatzichristodoulou G, Yang DY, Ring JD, et al. Multicenter Experience Using Collagen Fleece for Plaque Incision With Grafting to Correct Residual Curvature at the Time of Inflatable Penile Prosthesis Placement in Patients With Peyronie's Disease. J Sex Med 2020;17:1168-1174.

摘要

背景

在患有 Peyronie 病(PD)的患者中,放置可充气阴茎假体(IPP)时常需要辅助操作来纠正残余弯曲。

目的

我们介绍了在患有中重度 PD 的患者中,使用胶原蛋白绒片作为移植物进行斑块切开和移植(PIG)的多中心经验。

方法

我们回顾性分析了在 3 个中心接受 Tachosil(Baxter,IL)胶原蛋白绒片 PIG 治疗的 51 例接受 IPP 的患者。使用了 Coloplast(明尼苏达州明尼阿波利斯)IPP 装置。使用卡方分析评估与残余弯曲、翻修和患者满意度相关的因素。

结果

我们评估了术后结果,包括与残余弯曲、翻修和患者满意度相关的因素。

结论

在我们的多中心研究中,患者经历了显著的曲线矫正,并发症最小,在少数有持续轻度弯曲的患者中,发现严重的术前弯曲(>60°)是唯一的危险因素。

局限性

本研究的局限性包括回顾性研究设计、缺乏对照组和随访时间较短。

Hatzichristodoulou G、Yang DY、Ring JD 等人。多中心经验使用胶原蛋白绒片在患有 Peyronie 病的患者中,在放置可充气阴茎假体时,通过斑块切开和移植物矫正残余弯曲。性医学杂志 2020;17:1168-1174.

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