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成人白膜无切口折叠术治疗孤立性先天性阴茎腹侧弯曲:一项前瞻性病例系列研究

Isolated ventral congenital penile curvature treated by incisionless plication of tunica albuginea in adults: A prospective case series.

作者信息

Gadelkareem Rabea A, Elgendy Mohammed A, Kurkar Adel, El-Taher Ahmed M, Abdelkawi Islam F

机构信息

Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Curr Urol. 2023 Sep;17(3):206-212. doi: 10.1097/CU9.0000000000000121. Epub 2022 Aug 22.

Abstract

BACKGROUND

Numerous surgical techniques are available for the correction of isolated ventral congenital penile curvature (IVCPC). This study aimed to assess the outcomes and predictors of IVCPC treatment in adults using an incisionless plication technique.

MATERIALS AND METHODS

This prospective case series examined patients with IVCPC who were treated in our hospital between October 2017 and February 2020 using incisionless plication of the tunica albuginea (Essed-Schroeder technique) with a covering pair of absorbable sutures. The primary outcomes were successful correction (defined as a residual curvature ≤15 degrees) and patient satisfaction. Postoperative follow-ups were performed at 3, 6, and 12 months.

RESULTS

A total of 23 patients were treated for IVCPC with a mean (range) age of 25.3 (18-31) years. Eighteen patients (78.3%) were single with cosmetic complaints, whereas the other 5 patients (21.7%) were married and presented with a difficult vaginal intromission. The mean (range) curvature, length, and operative time were 40 (30-50) degrees, 15 (10-19) cm, and 82 (65-100) minutes, respectively. Postoperative penile pain and numbness occurred in 13 patients (56.5 %) and 7 patients (30.4%) only within the first month, respectively. Palpable suture knots were reported in 15 patients (65.5%) without being bothersome up to 12 months. The postoperative means (ranges) of penile curvature and length were significantly different from that of the preoperative values at 3 (5 [0-20] degrees and 14.5 [9-18.5] cm), 6 (5 [0-20] degrees and 14.5 [9-18.5] cm), and 12 months (5 [0-30] degrees and 14.5 [9-18.5] cm; all < 0.001). Age, preoperative penile curvature, penile length, postoperative pain, wound infections, and knot palpation insignificantly affected curvature recurrence. Seventeen patients (73.9%) were very satisfied with their surgical outcomes.

CONCLUSIONS

Incisionless plication of the tunica albuginea is effective and safe for the correction of IVCPC in adults with high success and patient satisfaction rates.

摘要

背景

有多种手术技术可用于矫正孤立性先天性阴茎腹侧弯曲(IVCPC)。本研究旨在评估采用无切口折叠技术治疗成人IVCPC的效果及预测因素。

材料与方法

本前瞻性病例系列研究对2017年10月至2020年2月期间在我院接受治疗的IVCPC患者进行了检查,采用白膜无切口折叠术(Essed-Schroeder技术)并辅以一对可吸收缝线覆盖。主要结局指标为矫正成功(定义为残余弯曲≤15度)和患者满意度。术后分别在3个月、6个月和12个月进行随访。

结果

共有23例患者接受了IVCPC治疗,平均(范围)年龄为25.3(18 - 31)岁。18例患者(78.3%)为单身,有外观方面的主诉,而另外5例患者(21.7%)已婚,存在阴道插入困难的问题。平均(范围)弯曲度、阴茎长度和手术时间分别为40(30 - 50)度、15(10 - 19)厘米和82(65 - 100)分钟。术后仅在第一个月分别有13例患者(56.5%)出现阴茎疼痛,7例患者(30.4%)出现阴茎麻木。15例患者(65.5%)报告可触及缝线结,但在12个月内均未造成困扰。术后3个月(5 [0 - 20]度和14.5 [9 - 18.5]厘米)、6个月(5 [0 - 20]度和14.5 [9 - 18.5]厘米)和12个月(5 [0 - 30]度和14.5 [9 - 18.5]厘米;均P < 0.001)时阴茎弯曲度和长度的术后平均值(范围)与术前值有显著差异。年龄、术前阴茎弯曲度、阴茎长度、术后疼痛、伤口感染和可触及缝线结对弯曲度复发的影响不显著。17例患者(73.9%)对手术结果非常满意。

结论

白膜无切口折叠术治疗成人IVCPC有效且安全,成功率和患者满意度高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ebe/10337818/eb8a9ffee21d/curr-urol-17-206-g001.jpg

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