Madec F-X, Akakpo W, Ferretti L, Carnicelli D, Terrier J-É, Methorst C, Beley S, Graziana J-P, Hupertan V, Yiou R, Morel Journel N, Marcelli F, Faix A, Huyghe É
Service d'urologie, hôpital Foch, Suresnes, France.
Service d'urologie, centre médicochirurgical Ambroise-Paré, Neuilly-sur-Seine, France.
Prog Urol. 2022 Sep;32(10):656-663. doi: 10.1016/j.purol.2022.04.010. Epub 2022 Jun 5.
Guidelines regarding congenital penile curvature (CPC) are lacking, and this pathology has not been the subject of French recommendations to date. The Andrology and Sexual Medicine Committee (CAMS) of the French Association of Urology (AFU) propose a series of clinical practice recommendations (CPR) by answering five clinical questions concerning the diagnosis and treatment of this pathology.
After a bibliographic research between 2000 and 2021, followed by a critical reading according to the CRP method. These recommendations were written to answer five questions: (1) What are the different types of CPC? (2) What are the reasons for consultation? (3) What are the assessment methods for CPCs and their consequences? (4) What are the indications for CPCs treatment? (5) What are the corrective modalities for the treatment of CPC?
There are two main phenotypes: CPC type 4 (the most common) and chordee without hypospadias. The diagnosis of CPC is clinical and established through enquiry and clinical examination associated with photos of the erect penis. Support can be offered if the curvature is responsible for a disability and/or sexual dissatisfaction linked to a deformation making penetration difficult and/or in the event of significant psychological impact. Only surgical treatments have demonstrated their effectiveness. For type 4 CPCs, corporoplasty (excisional, incisional, or incisionless techniques) is the gold standard.
These recommendations provide support for the management of patients consulting with CPC.
目前缺乏关于先天性阴茎弯曲(CPC)的指南,并且迄今为止该病症尚未成为法国相关建议的主题。法国泌尿外科学会(AFU)的男科学与性医学委员会(CAMS)通过回答有关该病症诊断和治疗的五个临床问题,提出了一系列临床实践建议(CPR)。
在2000年至2021年进行文献研究之后,按照CRP方法进行批判性阅读。这些建议旨在回答五个问题:(1)CPC有哪些不同类型?(2)咨询的原因是什么?(3)CPC的评估方法及其后果有哪些?(4)CPC治疗的适应症是什么?(5)CPC治疗的矫正方式有哪些?
有两种主要表型:4型CPC(最常见)和无尿道下裂的阴茎下弯。CPC的诊断是临床诊断,通过询问病史以及结合勃起阴茎照片的临床检查来确定。如果弯曲导致残疾和/或与使插入困难的畸形相关的性不满,和/或在有重大心理影响的情况下,可以提供支持。只有手术治疗已证明其有效性。对于4型CPC,阴茎成形术(切除、切开或无切开技术)是金标准。
这些建议为患有CPC前来咨询的患者的管理提供了支持。