Complications of porcine small intestine submucosa graft for Peyronie's disease
Complications of porcine small intestine submucosa graft for Peyronie's disease
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DOI：
10.1016/j.juro.2006.09.051
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发表时间：
2007-02-01
影响因子：
6.6
通讯作者：
Lue, Tom F.
中科院分区：
文献类型：
--
作者：
Breyer, Benjamin N.;Brant, William O.;Lue, Tom F.
目的：我们报道猪小肠粘膜下层矫正佩罗尼氏病引起的阴茎弯曲的结果和并发症。材料和方法：回顾性研究了严重阴茎弯曲（大于60度）需要手术矫正性功能的患者。术前所有患者均接受病史、体格检查和阴茎超声检查。其中19例患者行肠粘膜下i层手术膜移植。术后通过门诊和电话访谈对患者进行评估。结果：2002年3月至2005年7月，本组共19例患者，年龄46 ~ 69岁，平均54岁，行小肠粘膜下层切开或切除移植术。平均随访时间为15个月（3 ~ 43个月）。患者报告手术后性交时阴茎疼痛减轻。男性性健康量表得分无差异。术前12名男性（63%）有勃起功能障碍，定义为性健康调查男性小于21岁，而10名（53%）报告术后勃起功能障碍。19例患者中有7例（37%）有复发性阴茎弯曲（大于10度），5例（26%）有复发性佩罗尼病斑块。我们的并发症发生率为37%，包括移植物部位血肿5例（26%），移植物感染1例（5%），Peyronie病复发1例（5%）。结论：小肠粘膜下层具有移植应用的潜力，因为它易于使用且易得。我们的经验导致37%的并发症发生率，超过了先前报道的隐静脉移植修复。
Purpose: We report outcomes and complications of the use of porcine small intestine submucosa for correcting penile curvature due to Peyronie's disease.Materials and Methods: A retrospective study was performed in patients with severe penile curvature (greater than 60 degrees) requiring surgical correction for sexual function. Preoperatively all patients underwent evaluation, including history, physical and penile duplex ultrasound. Of these patients 19 underwent tunical grafting with I-layer Surgisis@ small intestine submucosa. Postoperatively patients were evaluated with clinic visits and telephone interviews to assess results.Results: A total of 19 patients 46 to 69 years old (mean age 54) were treated with tunical incision or excision and grafting with small intestine submucosa between March 2002 and July 2005. Average followup was 15 months (range 3 to 43). Patients reported less penile pain with intercourse after surgery. There was no difference in Sexual Health Inventory for Men scores. Preoperatively 12 men (63%) had erectile dysfunction, defined as Sexual Health Inventory for Men less than 21, while 10 (53%) reported postoperative erectile dysfunction. Seven of the 19 patients (37%) had recurrent penile curvature (greater than 10 degrees) and 5 (26%) had recurrent Peyronie's disease plaque. Our complication rate was 37%, including hematoma at the graft site in 5 cases (26%), graft infection in 1 (5%) and Peyronie's disease recurrence requiring plication in 1 (5%).Conclusions: Small intestine submucosa carries potential for grafting applications because it is easy to use and readily available. Our experience resulted in a 37% complication rate, which exceeds those previously reported with saphenous vein graft repair.