Small intestinal submucosa for patch grafting after plaque incision in the treatment of Peyronie's disease.
Small intestinal submucosa for patch grafting after plaque incision in the treatment of Peyronie's disease.
复制标题
切开斑块后进行小肠粘膜下层补片移植治疗佩罗尼病。
DOI：
10.1590/s1677-55382008000200009
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
S. Brandes
中科院分区：
文献类型：
--
作者：
Eugene W. Lee;A. Shindel;S. Brandes
目的
报告猪小肠粘膜下层（SIS）作为移植材料在佩罗尼病（PD）手术治疗中的结果。
材料和方法
我们对PD男性患者进行了一项回顾性病历审查，这些患者在我们机构由一名外科医生通过斑块“H”切口和4层SIS补片移植（Cook，布卢明顿，IN）进行了曲率矫正手术。术前和术后评估弯曲程度和方向、性功能和合并症。
结果
确定了13名患者。平均年龄为57 ± 8岁，范围为42-70岁。中位随访时间为14个月，范围为3-89个月。就诊时，所有患者均报告阴茎弯曲。还报告了77%、69%、77%、62%和46%的患者分别出现阴道插入困难（通过性接触特征问卷-SEP 2的问题2确定）、可触及斑块、沙漏畸形、勃起困难和维持勃起困难（通过SEP 3确定）。原发畸形的平均和中位弯曲度分别为71度和67.5度。3例患者在不同方向的二次弯曲小于30度。平均和中位数斑块大小分别为3.5和2.7平方厘米。7名患者植入了1枚移植物，6名患者植入了2枚移植物，平均尺寸为15 +/- 0 cm 2。
结论
对于患有PD的患者，SIS移植可以实现功能性直勃起，具有持久的结果，但勃起功能障碍的发生率相对较高。SIS是一种可行的移植材料，可用于PD的手术治疗。
OBJECTIVE
Report the results using porcine small intestinal submucosa (SIS) as a graft material in the surgical management of Peyronie's disease (PD).
MATERIALS AND METHODS
We performed a retrospective chart review of men with PD who underwent surgical correction of the curvature by plaque "H" incision and patch grafting with 4-ply SIS (Cook, Bloomington, IN) by a single surgeon at our institution. Degree and direction of curvature, sexual function, and co-morbidities were assessed pre- and postoperatively.
RESULTS
Thirteen patients were identified. Mean age was 57 +/- 8, range 42-70 years. Median follow-up was 14 months, range 3-89 months. At presentation, all reported penile curvature. Also reported were difficulty with vaginal penetration (determined by question number 2 of the sexual encounter profile questionnaire - SEP2), palpable plaque, hourglass deformity, difficulty with firmness, and difficulty with sustaining erection (determined by SEP3) in 77%, 69%, 77%, 62%, and 46% of patients, respectively. Mean and median degrees of curvature of the primary deformity were 71 and 67.5 degrees, respectively. Three patients had secondary curves of less than 30 degrees in a different direction. Mean and median plaque size were 3.5 and 2.7 cm2, respectively. Seven patients had one graft and six patients had two grafts placed with a mean size of 15 +/- 0 cm2.
CONCLUSIONS
For the patient with PD, SIS grafting can achieve a functionally straight erection with durable results yet with relatively high rates of erectile dysfunction. SIS is a viable graft material for use in the surgical treatment of PD.