Garaz Radion, Amend Bastian, Stenzl Arnulf, Bedke Jens, Hennenlotter Jörg, Rochwarger Alexander, Schürch Christian M, Tsaur Igor, Rausch Steffen
Department of Urology, Eberhard Karls University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
Department of Urology and Transplantation Surgery, Stuttgart Hospital, Stuttgart, Germany.
Int Urol Nephrol. 2025 Feb;57(2):355-362. doi: 10.1007/s11255-024-04222-2. Epub 2024 Oct 8.
Collagen fleece grafting (CFG) is the recommended treatment for severe Peyronie's disease (PD) curvature (> 60°), but its efficacy in mild/moderate curvatures remains uncertain. This study evaluated CFG in patients with mild/moderate curvatures (< 60°) at risk of penile shortening or symptomatic plaque.
A retrospective review was conducted on patients who underwent surgical treatment for PD using plaque incision or partial plaque excision and CFG. Clinical parameters and complications were reviewed. Subgroup analysis was performed on patients with curvatures of > 60° and curvatures ≤ 60°.
89 patients with a median age of 59 years and a median curvature of 70 (20-90)° were identified. Dorsal curvature was predominant in 66% of cases, followed by lateral (16%), ventral (8%), and complex curvatures (10%). Partial plaque excision was performed in 98% of patients, with an average grafting area of 2.1 cm; 71% had a singular penile plaque, while 29% presented two or more plaques. The comparison between patients with curvatures ≤ 60° and > 60° revealed no significant differences in mean operation time (86.3 vs. 94.4 min, p = 0.13) or in the incidence of postoperative complications, including glans necrosis, hypoesthesia, ecchymosis, bleeding, hematoma, infection, residual curvature, revision surgery, or pain.
Early postoperative outcomes and complication rates following plaque incision or partial plaque excision and grafting with CFG were comparable in patients with mild/moderate and severe PD deformities. The technique may be a viable option with a similar risk profile for achieving penile straightening in selected PD cases, particularly when plication is not feasible.
胶原纤维植入术（CFG）是重度佩罗尼氏病（PD）阴茎弯曲（>60°）的推荐治疗方法，但其对轻/中度弯曲的疗效仍不确定。本研究评估了CFG在有阴茎缩短风险或有症状斑块的轻/中度弯曲（<60°）患者中的应用。
对接受PD手术治疗（采用斑块切开或部分斑块切除及CFG）的患者进行回顾性研究。回顾临床参数和并发症。对弯曲>60°和弯曲≤60°的患者进行亚组分析。
共纳入89例患者，中位年龄59岁，中位弯曲度为70（20 - 90）°。66%的病例以背侧弯曲为主，其次是外侧（16%）、腹侧（8%）和复杂弯曲（10%）。98%的患者进行了部分斑块切除，平均植入面积为2.1 cm；71%有单个阴茎斑块，29%有两个或更多斑块。弯曲≤60°和>60°的患者在平均手术时间（86.3对94.4分钟，p = 0.13）或术后并发症发生率（包括龟头坏死、感觉减退、瘀斑、出血、血肿、感染、残余弯曲、翻修手术或疼痛）方面无显著差异。
在轻/中度和重度PD畸形患者中，斑块切开或部分斑块切除及CFG植入术后的早期结果和并发症发生率相当。该技术可能是一种可行的选择，在特定的PD病例中实现阴茎伸直的风险相似，特别是在折叠不可行时。
