Rush University Medical Center Department of Urology, 1725 West Harrison Street, Chicago, IL, 60612, USA.
The Urology Group, 2000 Joseph E Sanker Blvd, Cincinnati, OH, 45212, USA.
Int J Impot Res. 2024 Apr;36(2):118-124. doi: 10.1038/s41443-023-00738-w. Epub 2023 Jul 19.
Peyronie's disease continues to be poorly understood. We characterize the presenting features of Peyronie's disease within a large cohort and elucidate the factors that correlate with surgical intervention. Univariate and multivariate analyses were performed on 1483 consecutive patients to assess pre-operative predictors of surgical intervention for Peyronie's disease. Overall, 1263 patients met inclusion criteria. Mean age was 55.4 ± 11.1 years with a mean duration of disease at presentation of 33.2 ± 42.5 months. Mean primary curvature was 49.8 ± 20.8°. Primary ventral curvature was present in 11.4% and 36.5% of patient had a multiplanar curvature. During penile duplex ultrasound evaluation indentation/narrowing deformities were appreciated in 76.0%, hourglass deformity in 10.1%, and hinge effect in 33.0% of patients. Calcification was seen in 30.1% of patients. Operative intervention occurred in 35.3% of patients. Degree of primary curvature (1.03 OR, p < 0.001), hourglass deformity (1.82 OR, p = 0.01), decreased tunical elasticity (1.20 OR, p = 0.03), and prior intralesional collagenase clostridium histolyticum injections (2.94 OR, p < 0.001) predicted surgical correction on multivariate analysis. Compared to historical studies, we found a higher incidence of severe degree of curvature (27.5% >60°), indentation deformities, hinge-effect, multiplanar curvature and penile calcifications. Ultimately, predictors of surgical intervention included those with worse erectile function and more severe characteristics.
佩罗尼病仍然知之甚少。我们在一个大型队列中描述了佩罗尼病的表现特征，并阐明了与手术干预相关的因素。对 1483 例连续患者进行了单因素和多因素分析，以评估佩罗尼病手术干预的术前预测因子。总体而言，1263 例患者符合纳入标准。平均年龄为 55.4 ± 11.1 岁，就诊时疾病平均持续时间为 33.2 ± 42.5 个月。平均原发性弯曲度为 49.8 ± 20.8°。原发性腹侧弯曲度存在于 11.4%的患者中，36.5%的患者存在多平面弯曲度。在阴茎双功能超声评估中，76.0%的患者出现压痕/狭窄变形，10.1%的患者出现沙漏畸形，33.0%的患者出现铰链效应。30.1%的患者有钙化。35.3%的患者接受了手术干预。原发性弯曲度（1.03 OR，p<0.001）、沙漏畸形（1.82 OR，p=0.01）、鞘膜弹性降低（1.20 OR，p=0.03）和既往腔内胶原酶注射（2.94 OR，p<0.001）在多因素分析中预测手术矫正。与历史研究相比，我们发现更严重的弯曲度（27.5% >60°）、压痕变形、铰链效应、多平面弯曲度和阴茎钙化的发生率更高。最终，手术干预的预测因素包括勃起功能较差和特征更严重的患者。
