Eslahi Ali, Ahmed Faisal, Askarpour Mohammad Reza, Nikbakht Hossein-Ali, Shamohammadi Iman, Ghasemi Payam, Alimardani Hanieh, Ebrahimi Bahareh
Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Asian J Urol. 2024 Jul;11(3):497-503. doi: 10.1016/j.ajur.2023.03.005. Epub 2023 Aug 2.
Peyronie's disease (PD) is an abnormal wound healing in the penile tunica albuginea. After fibrotic plaque excision, different graft materials have been used to repair the defects, but the optimal graft remains unknown. This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.
A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021. The patients were divided into two groups depending on the type of graft used. For 15 patients in Group B, testicular tunica vaginalis grafts were used to repair the defect, while for 18 patients in Group A, bovine pericardium grafts were used. Data of the patient's age, comorbidities, sexual function, penile curvature, postoperative complications, need for further treatment, change in penile length, and satisfaction were gathered and compared between the groups. Sexual function was evaluated using the 5-item version of the International Index of Erectile Function (IIEF-5), and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.
There was no difference in age, comorbidities, degree of curvature, perioperative IIEF-5, operative time, plaque size, or complication rates. After surgery, a statistically significant improvement in curvature degree (<0.05) and satisfactory penile appearance (<0.05) were seen in both groups without any superiority between the two groups (=0.423 and =0.840, respectively). With a 30-month follow-up, the IIEF-5 was consistent in both groups, with no statistical significance between the groups (=0.492). The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance (=0.255 and =0.101, respectively).
Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.
佩罗尼氏病（PD）是阴茎白膜的异常伤口愈合。在纤维化斑块切除术后，已使用不同的移植材料来修复缺损，但最佳移植材料仍未知。本研究旨在比较严重PD患者中睾丸鞘膜移植和牛心包移植的功能结局。
对2015年9月至2021年5月期间接受部分斑块切除和移植的33例PD患者进行回顾性比较研究。根据所用移植材料的类型将患者分为两组。B组15例患者使用睾丸鞘膜移植修复缺损，而A组18例患者使用牛心包移植。收集并比较两组患者的年龄、合并症、性功能、阴茎弯曲度、术后并发症、进一步治疗需求、阴茎长度变化和满意度等数据。使用国际勃起功能指数（IIEF-5）的5项版本评估性功能，术后阴茎弯曲度小于20度被认为是成功的干预。
年龄、合并症、弯曲度、围手术期IIEF-5、手术时间、斑块大小或并发症发生率方面无差异。术后，两组的弯曲度（<0.05）和阴茎外观满意度（<0.05）均有统计学意义的改善，两组之间无任何优势（分别为=0.423和=0.840）。随访30个月时，两组的IIEF-5一致，组间无统计学意义（=0.492）。手术期间阴茎长度的主要变化是增加，两组最后一次随访时仍为正值，无统计学意义（分别为=0.255和=0.101）。
睾丸鞘膜或牛心包移植进行部分斑块切除和阴茎成形术在治疗具有临床意义的男性PD患者中同样有效。
