Shukla Pushpendra Kumar, Singh Aditya Kumar, Trivedi Sameer, Dwivedi U S, Ramole Yashpal, Khan Faiz Ahmed, Pandey Manish
Department of Urology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Urol Ann. 2024 Jul-Sep;16(3):227-232. doi: 10.4103/ua.ua_3_24. Epub 2024 Jul 3.
Peyronie's disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity.
This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years.
The mean operative time was 126.31 ± 21.45 min. Additional Nesbit's plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances.
LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results.
佩罗尼氏病（PD）是白膜的局限性纤维化，可导致阴茎的解剖和功能改变。严重（>60°）和复杂弯曲的情况下需进行移植性阴茎成形术。颊黏膜是目前最常用的自体移植材料。舌黏膜的腹外侧与口腔其他部位具有相似的组织学特征。
本研究旨在从手术效果、性功能和供区并发症方面，测试舌黏膜移植（LMG）阴茎成形术在PD手术治疗中的疗效、安全性、耐久性和可重复性。这项前瞻性研究纳入了19例患有严重和复杂弯曲的PD患者，他们接受了LMG阴茎成形术。在计划的2周、3个月、6个月、1年和2年随访时评估手术和功能结果。
平均手术时间为126.31±21.45分钟。26%（5/19）的患者需要额外进行内斯比特折叠术以纠正残余畸形。89%（17/19）的患者实现了阴茎伸直（弯曲<10°）。63%（12/19）的患者术后阴茎长度增加（>1厘米），5%（1/19）的患者阴茎缩短。11%（2/19）的患者出现新发勃起功能障碍，平均随访20.66±5.37个月时，患者和伴侣的满意率分别为89%（17/19）和84%（16/19）。供区并发症极少，没有患者出现任何唾液变化或言语障碍。
LMG在畸形矫正、改善性功能和最小化供区发病率方面提供了优异的短期效果。该方法简单且可重复，需要进行更多病例、更长随访时间的多中心研究来证实这些良好结果。
