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初次植入与翻修植入在可充气阴茎假体中的应用:倾向评分匹配比较。

Primary versus revision implant for inflatable penile prosthesis: A propensity score-matched comparison.

机构信息

Department of Maternal and Child Health and Urological Sciences, 'Sapienza' University, Rome, Italy.

出版信息

Andrologia. 2021 Dec;53(11):e14240. doi: 10.1111/and.14240. Epub 2021 Sep 9.

Abstract

Inflatable penile prosthesis (IPP) provides excellent outcomes after virgin implants. However, few data on IPP after revision surgery are available. This study aimed at comparing the outcomes of IPP in patients undergoing primary or revision implant surgery. Patients who underwent revision implant surgery (Group 1) between 2013 and 2020 were identified. Overall, 20 patients (Group 1) could be matched with a contemporary matched pair cohort of surgery-naive patients (Group 2) in a 1:1 ratio. Patients in Group 2 had a significantly shorter operative time [median (IQR): 84 (65-97) vs. 65 (51-75) min; p = .01] and lower rate of overall complications (25% vs. 10%; p = .01). Of note, mean (SD) scores for the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire demonstrated high satisfaction and IPP efficacy in both Groups 1 and 2: functional domain [3.9 (1.0) vs. 4.0 (1.2); p = .4], personal [3.9 (1.1) vs. 4.0 (1.1); p = .3], relational [3.8 (1.3) vs. 3.9 (1.1); p = .5] and social [3.9 (1.1) vs. 4.0 (1.2); p = .2]. These results suggest that in experienced hands, IPP offers high satisfaction to both patients and partners even in the setting of revision implant. However, it is mandatory to inform those patients about the increased risk of perioperative complications.

摘要

可充式阴茎假体 (IPP) 在初次植入后能获得极好的效果。然而,关于翻修手术后 IPP 的数据很少。本研究旨在比较初次植入和翻修植入手术患者的 IPP 结果。

确定了 2013 年至 2020 年间接受翻修植入手术的患者(第 1 组)。总体而言,以 1:1 的比例在第 1 组中匹配了 20 名患者(第 1 组),与一组手术未接受过的对照患者(第 2 组)相匹配。第 2 组患者的手术时间明显缩短[中位数(IQR):84(65-97)比 65(51-75)分钟;p=0.01],且总体并发症发生率较低(25%比 10%;p=0.01)。值得注意的是,两组患者的生活质量和阴茎假体性生活质量问卷(QoLSPP)的平均(SD)评分均表现出高度满意度和 IPP 疗效:功能域[3.9(1.0)比 4.0(1.2);p=0.4]、个人[3.9(1.1)比 4.0(1.1);p=0.3]、关系[3.8(1.3)比 3.9(1.1);p=0.5]和社会[3.9(1.1)比 4.0(1.2);p=0.2]。

这些结果表明,即使在翻修植入的情况下,在有经验的医生手中,IPP 也能为患者及其伴侣带来高度的满意度。然而,必须告知这些患者围手术期并发症风险增加的情况。

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本文引用的文献

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Sexual Quality of Life and Satisfaction With Penile Prostheses.性健康状况和对阴茎假体的满意度。
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