Sokolakis Ioannis, Pyrgidis Nikolaos, Hatzichristodoulou Georgios
Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany.
Int J Impot Res. 2022 Apr;34(3):260-268. doi: 10.1038/s41443-020-00401-8. Epub 2021 Jan 15.
Grafting for the treatment of Peyronie's disease (PD) can be performed with autologous grafts, allografts, xenografts and synthetic grafts, with all available materials presenting their own characteristics. Still, there is a current arising interest in the use of collagen fleece (TachoSil) as grafting material. We generated an extensive literature review, aiming to assess the use of TachoSil in the treatment of PD. TachoSil is currently indicated in men with PD and preserved erectile function for defect closure after partial plaque excision or incision. In addition, it is indicated for residual curvature correction during penile prosthesis implantation (PPI) in patients with PD and severe erectile dysfunction. Our literature search identified 12 studies evaluating the role of TachoSil for PD surgical treatment. We presented the surgical procedure of TachoSil grafting for the treatment of complex penile curvatures with or without simultaneous PPI and summarized the available evidence on the matter. Identified studies suggest that TachoSil is considered highly effective, reliable and safe in patients with PD. Moreover, it displays favorable properties compared to other grafting materials. It should be stressed that, despite some limitations of available data, TachoSil presents key strengths, which include easy application, decreased operative times, no risk of damaging the implant during PPI, preservation or increase in penile length, fewer cases of penile hypoesthesia, low risk of other adverse events, additional hemostatic effects and low cost. Still, randomized trials comparing TachoSil with different grafting materials are necessary to establish its efficacy.
佩罗尼氏病(PD)的治疗可采用自体移植物、同种异体移植物、异种移植物和合成移植物进行,所有可用材料都有其自身特点。尽管如此,目前人们对使用胶原纤维网(速即纱)作为移植材料的兴趣与日俱增。我们进行了广泛的文献综述,旨在评估速即纱在PD治疗中的应用。速即纱目前适用于患有PD且保留勃起功能的男性,用于部分斑块切除或切开后闭合缺损。此外,它还适用于患有PD和严重勃起功能障碍的患者在阴茎假体植入(PPI)期间矫正残余弯曲。我们的文献检索确定了12项评估速即纱在PD手术治疗中作用的研究。我们介绍了速即纱移植治疗复杂阴茎弯曲(无论是否同时进行PPI)的手术过程,并总结了关于此事的现有证据。已确定的研究表明,速即纱在PD患者中被认为是高效、可靠且安全的。此外,与其他移植材料相比,它具有良好的特性。应该强调的是,尽管现有数据存在一些局限性,但速即纱具有关键优势,包括易于应用、手术时间缩短、在PPI期间不会有损坏植入物的风险、保持或增加阴茎长度、阴茎感觉减退的病例较少、其他不良事件风险低、具有额外的止血作用以及成本低。尽管如此,仍需要进行将速即纱与不同移植材料进行比较的随机试验来确定其疗效。