Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany.
Department of Urology, Technical University of Munich, Munich, Germany.
J Urol. 2021 Nov;206(5):1276-1282. doi: 10.1097/JU.0000000000001933. Epub 2021 Jul 6.
We describe the sealing technique with collagen fleece in patients with advanced Peyronie's disease (PD) and provide the prospective long-term outcomes.
We performed a multicenter cohort study in patients with preserved erectile function and stable PD that precluded sexual intercourse. All patients underwent partial plaque excision with collagen fleece grafting. The applied technique is explained through a high-quality video accompanied by relevant animations. After hospital discharge, all patients were assessed at 1, 4 and 24 weeks after treatment. Subsequently, they presented for an additional long-term evaluation.
From December 2004 to June 2015, 367 patients underwent surgery. Of these, 319 (86.9%) presented for the long-term evaluation and were included in the present study. At a median operative time of 79.8 minutes (range 50-130), total straightness of the penis was achieved in 299 cases (93.7%) and mean±SD penile length increased by 1.1±0.6 cm (p=0.017). After a median followup of 47.2 months (range 12-100), 291 patients (91.2%) presented with complete penile straightness. The penile glans sensation returned to the preoperative levels in 300 cases (94%). Only 11 cases of treatment-related grade 1 Clavien-Dindo complications were reported. Erectile function improved in 78 participants (24.5%) and remained unchanged in 191 (59.8%), whereas it was worsened in 50 (15.7%). Overall, the patient satisfaction rate was 87.8% and the partner satisfaction rate was 84.3%.
Grafting with collagen fleece in patients with advanced PD is a safe and effective procedure that reduces operative time, provides an additional hemostatic effect and represents a cost-effective technique.
我们描述了在晚期 Peyronie 病（PD）患者中使用胶原绒毡进行密封的技术，并提供了前瞻性的长期结果。
我们在勃起功能正常且 PD 稳定且不影响性生活的患者中进行了一项多中心队列研究。所有患者均接受了胶原绒毡移植的部分斑块切除术。应用技术通过附有相关动画的高质量视频进行解释。出院后，所有患者在治疗后 1、4 和 24 周接受评估。随后，他们接受了额外的长期评估。
2004 年 12 月至 2015 年 6 月，367 例患者接受了手术。其中 319 例（86.9%）接受了长期评估并纳入本研究。手术时间中位数为 79.8 分钟（范围 50-130），299 例（93.7%）获得阴茎完全伸直，平均阴茎长度增加 1.1±0.6cm（p=0.017）。中位随访 47.2 个月（范围 12-100）后，291 例（91.2%）患者阴茎完全伸直。300 例（94%）患者的阴茎龟头感觉恢复到术前水平。仅报告了 11 例治疗相关的 1 级 Clavien-Dindo 并发症。78 例患者（24.5%）的勃起功能改善，191 例（59.8%）无变化，50 例（15.7%）恶化。总体而言，患者满意度为 87.8%，伴侣满意度为 84.3%。
在晚期 PD 患者中使用胶原绒毡移植是一种安全有效的方法，可缩短手术时间，提供额外的止血效果，是一种具有成本效益的技术。
