Department of Urology and Robotic Surgery, Hospital Universitario La Zarzuela, Madrid, Spain.
Department of Urology and Andrology, NU Hospitals, Bengaluru, India.
Int J Impot Res. 2021 Sep;33(6):616-619. doi: 10.1038/s41443-020-0325-6. Epub 2020 Jul 8.
The aim of this study was to study the clinical effectiveness of a structured home modeling (HM) protocol in Peyronie's disease (PD) patients who have residual curvature up to 45° after inflatable penile prosthesis (PP) placement. A total of 92 patients with PD and coexistent refractory erectile dysfunction received inflatable PP. If residual curvature after manual modeling (MM) was more than 45°, incision-grafting was performed. If curvature was <45° after MM, patients were instructed to perform HM daily for 6 months, after 4 weeks from PP implantation. The mean preoperative penile curvature was 39.4 ± 5.7° (30-60). Sixteen (17.4%) patients required incision-grafting and the remaining 76(82.6%) patients followed HM protocol. The mean postoperative residual curvature after MM was 29.7 ± 3.2° (5-50). Sixty-five (85.5%) patients who underwent HM had 10° or less residual curvature after 3 months and 72 (94.7%) patients had 10° or less residual curvature after 6 months. Seventy (92.1%) patients responded as satisfied or very satisfied on the questionnaire with the outcome after 6 months. HM of the penis over Inflatable PP may straighten the penis without the need for an additional surgical maneuver in vast majority of the PD patients having residual curvature of <45°.
本研究旨在探讨结构家庭模型(HM)方案在接受可膨胀 penile 假体(PP)植入后残余弯曲度达 45°的 Peyronie 病(PD)患者中的临床疗效。92 例 PD 合并难治性勃起功能障碍患者接受了可膨胀 PP。如果手动模型(MM)后残余弯曲度大于 45°,则进行切口-移植术。如果 MM 后曲率<45°,则指导患者在 PP 植入后 4 周开始每天进行 HM,持续 6 个月。术前阴茎弯曲度平均为 39.4±5.7°(30-60)。16 例(17.4%)患者需要切口-移植术,其余 76 例(82.6%)患者遵循 HM 方案。MM 后残余弯曲度平均为 29.7±3.2°(5-50)。65 例(85.5%)接受 HM 的患者在 3 个月后残余弯曲度为 10°或更小,72 例(94.7%)患者在 6 个月后残余弯曲度为 10°或更小。70 例(92.1%)患者在 6 个月后对问卷的结果表示满意或非常满意。HM 可使阴茎变直,无需在大多数残余弯曲度<45°的 PD 患者中进行额外的手术操作。