Penile traction therapy for treatment of Peyronie's disease: A single-center pilot study
Penile traction therapy for treatment of Peyronie's disease: A single-center pilot study
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DOI：
10.1111/j.1743-6109.2008.00814.x
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发表时间：
2008-06-01
影响因子：
3.5
通讯作者：
Taylor, Frederick L.
中科院分区：
文献类型：
--
作者：
Levine, Laurence A.;Newell, Mark;Taylor, Frederick L.
介绍。佩罗尼氏病（PD）是一种阴茎纤维化疾病，其病因生理学尚不清楚。目前，还没有可靠的非手术治疗方法。本研究回顾了我们的经验，阴茎外牵引治疗纠正畸形相关的这种疾病。目的：探讨延长阴茎外牵引治疗前列腺增生的非手术治疗效果。10名男性PD患者使用FastSize阴茎扩展器完成了牵引治疗的非对照先导研究。几乎所有（90%）患者之前的药物治疗都失败了。唯一治疗方法为牵引，每天2-8小时，持续治疗6个月。所有受试者均接受治疗前和治疗后的体格检查，包括拉伸松弛阴茎长度（SPL）和生物等距测量。主要结果测量。在治疗前后用动态双工超声测量勃起时的曲率和围度。通过国际勃起功能和男性勃起困难生活质量指数（QOL-MED）问卷进一步评估勃起和性功能。在治疗后3个月和6个月，测量SPL并记录患者对畸形的主观评价。主观上，所有男性都注意到曲度减少，估计在10-40度，阴茎长度增加（1-2.5厘米），并在凹陷或缩小的区域增加周长。客观测量表明，所有男性的曲度从10-45度减小；平均降低33%（51-34度）。4例男性中有4例在矫正铰链效应后，SPL增加0.5 ~ 2.0 cm，勃起周长增加0.5 ~ 1.0 cm。国际勃起功能指数-勃起功能领域从18.3-23.6组增加。在这个小系列中，QOL-MED对生活质量的改变没有统计学意义。没有出现皮肤变化、溃疡、感觉减退或僵硬度下降等不良事件。延长每日阴茎外牵引治疗是非手术治疗帕金森病的新途径。鉴于这项初步研究中所指出的反应，进一步的研究似乎是有必要的。
Introduction. Peyronie's disease (PD) is a fibrotic disorder of the penis whose etiopathophysiology remains unclear. At this time, there is no known reliable nonsurgical treatment. This study reviews our experience with external penile traction therapy to correct the deformity associated with this disorder.Aim. To evaluate prolonged external penile traction as a nonsurgical treatment for PD.Methods. Ten men with PD completed this noncontrolled pilot study of traction therapy using the FastSize Penile Extender. Nearly all (90%) had failed prior medical therapy. Traction was applied as the only treatment for 2-8 hours/day for 6 months. All subjects underwent pre- and post-treatment physical examination including measurement of stretched flaccid penile length (SPL) and biothesiometry.Main Outcome Measures. Curvature and girth were measured during erection before and after treatment with dynamic duplex ultrasound. Assessment of erectile and sexual function was further assessed with the International Index of Erectile Function and Quality of Life Specific to Male Erection Difficulties (QOL-MED) questionnaires. At 3 and 6 months post-treatment, SPL was measured and subjective assessment of deformity by the patient was recorded.Results. Subjectively all men noted reduced curvature estimated at 10-40 degrees, increased penile length (1-2.5 cm) and enhanced girth in areas of indentation or narrowing. Objective measures demonstrated reduced curvature in all men from 10-45 degrees; average reduction for the group was 33% (51-34 degrees). SPL increased 0.5-2.0 cm and erect girth increased 0.5-1.0 cm with correction of hinge effect in four out of four men. International Index of Erectile Function-erectile function domain increased from 18.3-23.6 for the group. Changes in quality of life by QOL-MED were not found to be statistically significant in this small series. There were no adverse events including skin changes, ulcerations, hypoesthesia or diminished rigidity.Conclusion. Prolonged daily external penile traction therapy is a new approach for the nonsurgical treatment of PD. Further study appears warranted given the response noted in this pilot study.