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阴茎骨折手术修复后勃起功能障碍和阴茎弯曲的长期结局及危险因素

Long-term outcomes and risk factors for erectile dysfunction and penile curvature after surgical penile fracture repair.

作者信息

Senel Samet, Gultekin Huseyin, Ozgirgin Giray, Boyaci Lutfi Ihsan, Biyikoglu Melih, Ceviz Kazim, Arabaci Hasan Batuhan, Uzun Emre, Koudonas Antonios

机构信息

Ankara City Hospital, Department of Urology, Ankara, Türkiye.

Mus State Hospital, Department of Urology, Mus, Türkiye.

出版信息

Int J Impot Res. 2025 Aug 2. doi: 10.1038/s41443-025-01146-y.

Abstract

Long-term outcomes of penile fracture (PF) include erectile dysfunction (ED) and penile curvature. In this study, we aimed to present the functional and anatomical results of 182 patients who underwent PF repair surgery and to reveal the risk factors for ED and penile curvature in a relatively long follow-up period. Thirty (16.5%) patients suffered from ED and 18 (9.9%) patients had penile curvature, respectively in a median follow-up period of 66 (39-111) months. Presence of bilateral fractures (OR = 7.806; 95% CI = 2.083-29.261; p = 0.002), larger tunical defect size (OR = 1.099; 95% CI = 1.036-1.164; p = 0.002) and longer time between fracture and surgery (OR = 1.095; 95% CI = 1.036-1.157; p = 0.001) were stated as the independent risk factors for ED. Only larger tunical defect size was found as an independent risk factor for penile curvature (OR = 1.14; 95% CI = 1.063-1.221; p < 0.001). The cut-off values for predicting ED were 18.5 mm for tunical defect size, 14.5 h for time between fracture and surgery, and 41 years for age. The cut-off value for tunical defect size was 18.5 mm for penile curvature. Risk of ED increases among patients with extended tunical rupture and delayed surgical repair. Penile curvature manifests less frequently and seems to be associated with the size of the tunical defect.

摘要

阴茎骨折(PF)的长期后果包括勃起功能障碍(ED)和阴茎弯曲。在本研究中,我们旨在呈现182例行PF修复手术患者的功能和解剖学结果,并在相对较长的随访期内揭示ED和阴茎弯曲的危险因素。在中位随访期66(39 - 111)个月时,分别有30例(16.5%)患者出现ED,18例(9.9%)患者出现阴茎弯曲。双侧骨折(OR = 7.806;95%CI = 2.083 - 29.261;p = 0.002)、白膜缺损尺寸较大(OR = 1.099;95%CI = 1.036 - 1.164;p = 0.002)以及骨折与手术之间的时间间隔较长(OR = 1.095;95%CI = 1.036 - 1.157;p = 0.001)被认为是ED的独立危险因素。仅白膜缺损尺寸较大被发现是阴茎弯曲的独立危险因素(OR = 1.14;95%CI = 1.063 - 1.221;p < 0.001)。预测ED的白膜缺损尺寸临界值为18.5 mm,骨折与手术之间的时间间隔临界值为14.5小时,年龄临界值为41岁。阴茎弯曲的白膜缺损尺寸临界值为18.5 mm。白膜破裂延长和手术修复延迟的患者发生ED的风险增加。阴茎弯曲较少见,似乎与白膜缺损的大小有关。

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