Department of Urology, Ankara Etlik City Hospital, Ankara, Turkiye.
Department of Urology, Ürgüp State Hospital, Nevşehir, Turkiye.
Turk J Med Sci. 2024 May 23;54(5):893-899. doi: 10.55730/1300-0144.5865. eCollection 2024.
BACKGROUND/AIM: Peyronie's disease (PD) is known as a wound-healing disorder for which surgery remains the gold-standard treatment, but studies comparing graft materials are limited in the literature. The aim of this study was to evaluate the mid- and long-term results of patients who underwent surgery for PD with grafting procedures performed by a single experienced surgeon according to graft materials.
Patients who underwent corporoplasty between 2014 and 2020 with grafting procedures performed by a single experienced surgeon were retrospectively reviewed. A total of 115 patients were divided into 4 groups according to the grafting material used: autologous saphenous venous grafts, Group 1 (n = 36); porcine pericardial extracellular matrix grafts (EMGs; XenoGuard, MBP Medical Biomaterial Products GmbH, Neustadt-Glewe, Germany), Group 2 (n = 40); porcine intestinal submucosal EMGs (BioDesign, Cook Medical, Bloomington, IN, USA), Group 3 (n = 36); and bovine pericardial EMGs (Tutopatch, Tutogen Medical, Inc., Alachua, FL, USA), Group 4 (n = 43).
The mean operation time for Group 1 was longer than that of the other groups (p < 0.001). When comparing the groups in pairs, it was observed that the duration of postoperative loss of sensation (LOS) was significantly shorter in Group 3 (12.3 ± 5.3 days) and Group 4 (15.1 ± 3.1 days) (p < 0.05). There was a statistically significant difference between Groups 1 and 4 in penile length loss when the groups were compared in pairs (p = 0.017). There was a statistically significant difference between patients with penile curvatures of 0° to 59° and patients with curvatures of ≥60° in terms of duration of postoperative LOS (14.4 ± 5 vs. 16.4 ± 5.8 days, respectively; p = 0.028) and penile length loss (2.6 ± 5 vs. 5.7 ± 6.8 mm, respectively; p = 0.002).
The findings suggest that EMGs should be preferred to autologous venous grafts due to reduced postoperative erectile dysfunction, shorter operation time, and shorter recovery time for LOS.
背景/目的: 众所周知,佩罗尼氏病(PD)是一种创伤愈合障碍,手术仍然是其金标准治疗方法,但文献中比较移植物材料的研究有限。本研究的目的是根据移植物材料评估由一位经验丰富的外科医生进行的 PD 手术患者的中期和长期结果。
回顾性分析了 2014 年至 2020 年间接受由一位经验丰富的外科医生进行的 corporoplasty 手术并进行移植物手术的患者。根据使用的移植物材料,将 115 名患者分为 4 组:自体大隐静脉移植物,第 1 组(n = 36);猪心包细胞外基质移植物(XenoGuard,MBP Medical Biomaterial Products GmbH,Neustadt-Glewe,德国),第 2 组(n = 40);猪肠黏膜下细胞外基质移植物(BioDesign,Cook Medical,Bloomington,IN,USA),第 3 组(n = 36);牛心包细胞外基质移植物(Tutopatch,Tutogen Medical,Inc.,Alachua,FL,USA),第 4 组(n = 43)。
第 1 组的平均手术时间长于其他组(p < 0.001)。当比较组间配对时,第 3 组(12.3 ± 5.3 天)和第 4 组(15.1 ± 3.1 天)术后感觉丧失(LOS)的持续时间明显更短(p < 0.05)。组间配对比较时,第 1 组和第 4 组的阴茎长度损失存在统计学差异(p = 0.017)。在比较组间配对时,阴茎弯曲度为 0°至 59°的患者与弯曲度≥60°的患者在 LOS 术后持续时间(分别为 14.4 ± 5 天和 16.4 ± 5.8 天;p = 0.028)和阴茎长度损失(分别为 2.6 ± 5 毫米和 5.7 ± 6.8 毫米;p = 0.002)方面存在统计学差异。
研究结果表明,与自体静脉移植物相比,细胞外基质移植物应优先选择,因为它可以减少术后勃起功能障碍、缩短手术时间和 LOS 恢复时间。