Urology Clinic - A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Italy.
Urology Clinic - A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Italy; Neurourology Clinic - A.O.U. "Città della Salute e della Scienza" - Unità Spinale Unipolare, Italy.
J Sex Med. 2021 Jun;18(6):1099-1103. doi: 10.1016/j.jsxm.2021.02.012. Epub 2021 Apr 30.
Whilst there is a trend away from aggressive nonorgan sparing surgical treatments for malignant penile disease, a variety of penile preservation options exist but functional outcomes and patient reported outcomes (PROs) in this area are poorly reported to date.
The aim of this study is to report functional outcomes and PROs of total glans resurfacing (TGR) in a consecutive series of patients with lichen sclerosis (LS) or localized penile cancer (PC).
From 2004 to 2018 a consecutive series of patients underwent TGR for the management of LS or localized PC in a tertiary referral network. Patient clinical records and operative notes were retrospectively reviewed. Statistical analysis was conducted with Stata 12.
Urinary and sexual outcomes were recorded utilizing both the International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) validated questionnaires while PROs were extrapolated from a 5-item "ad hoc" telephone questionnaire administered at 1 year post procedure.
37 consecutive patients were enrolled. Histology results demonstrated LS in 16 patients, with the remaining 21 having a diagnosis of PC. The most common reasons for patient presentation were local pain (32.4%), pruritus (37.8%) and bleeding (29.7%). Median follow-up was 22 (IQR 13-77) months. Median age was 62 (IQR 55-68). Neither of the questionnaires assessing urinary and sexual function showed any significant deterioration after surgery. Glans sensitivity was fully maintained in 89.2% of cases. 94.5% of patients reported to be fully satisfied with the aesthetic appearance of the penis and would consider undergoing the same procedure again if necessary. 91.9% of patients would recommend the same procedure to someone else. An overall improvement of the quality of life was reported by 86.4% of patients.
TGR should be considered a treatment of choice for selected cases of benign or malignant penile lesions STRENGTHS AND LIMITATIONS: Our study has some limitations, the first being its retrospective nature. Furthermore, despite being one of the largest series to date, follow-up duration is somewhat limited and a control group is lacking.
TGR represents an excellent surgical option ensuring satisfactory voiding and sexual function, as well as cosmesis for selected cases of penile lesions. M. Preto, M. Falcone, G. Blecher, et al. Functional and Patient Reported Outcomes Following Total Glans Resurfacing. J Sex Med 2021;18:1099-1103.
尽管对于恶性阴茎疾病的侵袭性非保留器官的手术治疗呈下降趋势，但仍存在多种阴茎保留选择，但迄今为止，该领域的功能结果和患者报告的结果（PROs）报道甚少。
本研究旨在报告一系列局限性阴茎癌（PC）或硬化性苔藓（LS）患者接受全龟头表面重建（TGR）的功能结果和 PROs。
2004 年至 2018 年，在三级转诊网络中，连续系列患者接受 TGR 治疗 LS 或局限性 PC。回顾性分析患者的临床记录和手术记录。使用 Stata 12 进行统计分析。
37 例连续患者入组。组织学结果显示 16 例患者为 LS，其余 21 例患者诊断为 PC。患者就诊的最常见原因是局部疼痛（32.4%）、瘙痒（37.8%）和出血（29.7%）。中位随访时间为 22（IQR 13-77）个月。中位年龄为 62（IQR 55-68）岁。评估尿功能和性功能的两个问卷均未显示手术后任何显著恶化。89.2%的患者龟头敏感性完全保留。94.5%的患者对阴茎的美学外观完全满意，如果需要，会再次考虑接受相同的手术。91.9%的患者会向他人推荐相同的手术。86.4%的患者报告生活质量得到改善。
TGR 应被视为治疗选择，适用于良性或恶性阴茎病变。
本研究存在一些局限性，首先是其回顾性。此外，尽管是迄今为止最大的系列之一，但随访时间有些有限，且缺乏对照组。
TGR 是一种出色的手术选择，可为选定的阴茎病变病例提供满意的排尿和性功能以及美容效果。
