Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.
Department of Medical and Surgical Sciences of University of Foggia, Foggia, Italy.
Int J Impot Res. 2022 Sep;34(6):534-542. doi: 10.1038/s41443-021-00479-8. Epub 2021 Oct 30.
Severe Peyronie's disease (PD) and concomitant erectile dysfunction (ED) may require plaque incision/excision and grafting (PIG) as an adjunct to penile prosthesis implantation (IPP). Currently, there is no available consensus on the best graft material to use. Our aim was to systematically review graft materials used as patches following PIG + IPP. Literature search was performed in March 2021. Only original articles in English with a series of 10 or more patients were included. Overall, a total of 17 studies were included, corresponding to a cohort of 662 patients. The mean age ranged from 45 to 65 years and most patients had curvatures >45°. Average penile lengthening ranged from 1 to 3.5 cm, average residual curvatures from 0 to 20% and decreased glans sensitivity from 0 to 20%. Eighty to 100% of patients were satisfied with cosmetic and functional results. PIG + IPP with the use of various grafts offers promising results for the treatment of patients suffering from severe PD with concomitant ED. Unfortunately, the absence of high quality and comparative studies makes it difficult to establish the optimum graft. Therefore, the level of experience of the surgical team with one or more methods should guide their choice.
严重的 Peyronie 病 (PD) 和同时存在的勃起功能障碍 (ED) 可能需要斑块切开/切除和移植物 (PIG) 作为阴茎假体植入术 (IPP) 的辅助治疗。目前，对于使用哪种最佳移植物材料还没有共识。我们的目的是系统地回顾 PIG+IPP 后作为补丁使用的移植物材料。文献检索于 2021 年 3 月进行。仅纳入英文原始文章，且系列病例数大于等于 10 例。共纳入 17 项研究，共纳入 662 例患者。平均年龄为 45 至 65 岁，大多数患者的弯曲度大于 45°。平均阴茎延长长度为 1 至 3.5cm，平均残余弯曲度为 0 至 20%，龟头敏感度降低 0 至 20%。80%至 100%的患者对美容和功能结果满意。对于同时患有严重 PD 和 ED 的患者，使用各种移植物的 PIG+IPP 可获得良好的治疗效果。不幸的是，由于缺乏高质量和对比研究，难以确定最佳移植物。因此，手术团队对一种或多种方法的经验水平应指导他们的选择。
