Ainayev Yernur, Zhanbyrbekuly Ulanbek, Gaipov Abduzhappar, Kissamedenov Nurlan, Zhaparov Ulan, Suleiman Makhmud, Urazova Saltanat, Rakhmetova Nurila, Turebayev Dulat, Keulimzhayev Nurbol, Zhankina Rano, Khairli Gafur
Department of Urology and Andrology, Astana Medical University, Beibitshilik Street #49/a, 010000, Nur-Sultan, Kazakhstan.
School of Medicine, Department of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.
Int Urol Nephrol. 2022 Jul;54(7):1545-1550. doi: 10.1007/s11255-022-03223-3. Epub 2022 May 3.
Peyronie's disease (PD) is a two-phase progressive condition characterized by inelastic plaques in the tunica albuginea of the penis, leading to curvature of the penis. Men with PD also suffer from psychological distress, and sexual life and overall quality of life. Although the preferred surgical treatment modality in Peyronie's disease is plaque incision and grafting, there is lack of studies assessing the erectile function and penile vasculature after the treatment.
We aimed to evaluate the efficiency and safety of plaque incision and tunica vaginalis of testis grafting in PD.
This was a prospective analysis. Erectile dysfunction was assessed via International Index of Erectile Function Questionnaire (IIEF-5). Penile Doppler ultrasound was performed to assess peak systolic velocity (PSV) and end-diastolic velocity (EDV). Postoperative follow-ups were scheduled at 3, 12, and 24 months.
Twenty patients (mean age 47.2 ± 10.8 years) were included. The mean preoperative penile curvature was 48 ± 6.6°. The technical success rate was 100% at 3 months and 90% at 24 months. At follow-up visits, mean erect penile length was no different from the baseline. The baseline mean IIEF-5 score was 18.4 ± 2.5. The mean IIEF-5 score was 20.6 ± 2.6 at 24-month visit (p < 0.0001). Mean PSV significantly increased, while EDV significantly reduced after surgery. There were no serious complications related to surgery.
We conclude that surgical reconstruction of penile curvature with tunica vaginalis grafting was a safe and effective procedure in PD.
佩罗尼氏病（PD）是一种分两个阶段发展的疾病，其特征是阴茎白膜出现无弹性斑块，导致阴茎弯曲。患有佩罗尼氏病的男性还会遭受心理困扰，影响性生活和整体生活质量。尽管佩罗尼氏病首选的手术治疗方式是斑块切开和移植，但缺乏对治疗后勃起功能和阴茎血管系统的研究。
我们旨在评估斑块切开和睾丸鞘膜移植治疗佩罗尼氏病的有效性和安全性。
这是一项前瞻性分析。通过国际勃起功能指数问卷（IIEF-5）评估勃起功能障碍。进行阴茎多普勒超声检查以评估收缩期峰值流速（PSV）和舒张末期流速（EDV）。术后随访安排在3个月、12个月和24个月。
纳入20例患者（平均年龄47.2±10.8岁）。术前阴茎平均弯曲度为48±6.6°。3个月时技术成功率为100%，24个月时为90%。在随访中，勃起阴茎平均长度与基线无差异。基线时IIEF-5平均评分为18.4±2.5。24个月随访时IIEF-5平均评分为20.6±2.6（p<0.0001）。术后PSV显著增加，而EDV显著降低。没有与手术相关的严重并发症。
我们得出结论，睾丸鞘膜移植手术重建阴茎弯曲在佩罗尼氏病中是一种安全有效的方法。
