Jordan G H, Angermeier K W
Department of Urology, Eastern Virginia Medical School.
J Urol. 1993 Oct;150(4):1138-42. doi: 10.1016/s0022-5347(17)35708-7.
Most reports of surgical therapy for Peyronie's disease to date have not included detailed preoperative assessment of erectile function. To evaluate the relationship between preoperative erectile function and postoperative success, we reviewed 25 consecutive patients with Peyronie's disease who underwent surgery and evaluation with dynamic infusion cavernosometry and cavernosography preoperatively. Overall results of dynamic infusion cavernosometry and cavernosography revealed corporeal veno-occlusive dysfunction in 76% of the patients and inadequate arterial inflow parameters in 44%. Among 20 patients treated with plaque excision and dermal graft inlay, adequate postoperative erectile function for satisfactory intercourse occurred in 4 of 4 (100%) with an equilibrium accumulated intracorporeal pressure of greater than or equal to 70 mm. Hg, 9 of 12 (75%) with an equilibrium accumulated intracorporeal pressure of 40 to 65 mm. Hg and 1 of 4 (25%) with an equilibrium accumulated intracorporeal pressure of less than 35 mm. Hg. These data may be helpful to counsel patients before surgical therapy, and may explain some of the disparate results previously reported after plaque excision and dermal graft inlay on the basis of patient selection.
迄今为止，大多数关于佩罗尼氏病手术治疗的报告都未包括对勃起功能的详细术前评估。为了评估术前勃起功能与术后疗效之间的关系，我们回顾了连续25例接受手术治疗的佩罗尼氏病患者，并在术前对其进行了动态灌注海绵体测压和海绵体造影评估。动态灌注海绵体测压和海绵体造影的总体结果显示，76%的患者存在海绵体静脉闭塞功能障碍，44%的患者动脉流入参数不足。在20例行斑块切除及真皮移植镶嵌术的患者中，平衡累积海绵体内压大于或等于70mmHg的4例患者中，4例（100%）术后勃起功能良好，足以进行满意的性交；平衡累积海绵体内压为40至65mmHg的12例患者中，9例（75%）术后勃起功能良好；平衡累积海绵体内压小于35mmHg的4例患者中，1例（25%）术后勃起功能良好。这些数据可能有助于在手术治疗前为患者提供咨询，并可能解释先前在斑块切除及真皮移植镶嵌术后基于患者选择所报道的一些不同结果。
