Department of Urology, Mayo Clinic, Rochester, MN, USA.
Department of Urology, Rush University Medical Center, Chicago, IL, USA.
Int J Impot Res. 2023 Sep;35(6):569-576. doi: 10.1038/s41443-022-00600-5. Epub 2022 Aug 29.
We evaluated outcomes in patients undergoing penile prothesis (PP) implantation for erectile dysfunction (ED) and concurrent Peyronie's Disease (PD). A clinician-developed survey to assess satisfaction was sent to 354 patients who underwent PP placement from 2012-2018 by a single-surgeon. Results were compared based on the presence or absence of concurrent PD. 79 patients completed the survey (response rate 22%), including 38 patients (48%) with concurrent ED and PD (ED/PD). Mean follow-up was 31 months (standard deviation 19). 87% felt their condition was "very much" or "much" improved. There was no significant difference in patient-reported overall satisfaction with their PP or satisfaction with current penile length/girth based on the presence or absence of PD. 87% of patients with PD were satisfied with their degree of penile straightening after PP plus or minus concurrent straightening maneuvers such as modeling, plication, or incision/grafting. Sub-group analyses were performed to evaluate outcomes in those with concurrent PD/ED who required plaque incision/grafting at the time of PP placement for more severe deformity (n = 19). 47% of these patients were dissatisfied with their current penile length, compared with only 16% of those patients with PD/ED who did not require grafting (p = 0.05). In conclusion, the presence of PD alone may not impact PP satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length.
我们评估了因勃起功能障碍(ED)和同时存在的 Peyronie 病(PD)而行阴茎假体(PP)植入的患者的结局。一位临床医生开发了一份满意度评估调查问卷,发送给了 2012 年至 2018 年间由一位外科医生进行 PP 放置的 354 名患者。结果根据是否存在同时存在的 PD 进行比较。79 名患者完成了调查(回应率为 22%),其中 38 名患者(48%)同时患有 ED 和 PD(ED/PD)。平均随访时间为 31 个月(标准差 19)。87%的患者认为他们的病情“非常”或“有所”改善。根据 PD 的存在与否,患者对他们的 PP 的总体满意度或对当前阴茎长度/周长的满意度没有显著差异。87%的 PD 患者对 PP 加或不加同时进行的拉直操作(如塑形、折叠或切开/移植)后的阴茎拉直程度感到满意。进行了亚组分析,以评估在因更严重畸形而在 PP 放置时需要斑块切开/移植的同时存在 PD/ED 的患者中的结局(n=19)。这些患者中有 47%对当前的阴茎长度不满意,而 PD/ED 患者中不需要移植的患者只有 16%(p=0.05)。总之,单独存在 PD 可能不会影响 PP 的满意度,但基线畸形更严重且需要切开/移植的患者对包括阴茎长度在内的结局可能不太满意。