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首页> 外文期刊>The journal of sexual medicine >Preoperative clinical and diagnostic characteristics of patients who require delayed IPP after primary Peyronies repair.
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Preoperative clinical and diagnostic characteristics of patients who require delayed IPP after primary Peyronies repair.

机译：原发性Peyronies修复后需要延迟IPP的患者的术前临床和诊断特征。

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INTRODUCTION: Penile vascular abnormalities occur in a high proportion of patients with Peyronie's disease (PD). Penile duplex ultrasonography (PDU) and dynamic infusion cavernosometry and cavernosography (DICC) are tools that can be used to help tailor individualized treatment for patients undergoing surgical intervention for their PD. However, precisely which parameters can be used to predict those patients with PD at risk for developing erectile dysfunction (ED) after intervention without inflatable penile prosthesis (IPP) has not been previously elucidated. AIM: To evaluate preoperative vascular parameters that predispose PD patients for developing ED after intervention without IPP. METHODS: Twenty-six patients receiving surgical intervention for their PD at a single center were retrospectively identified. Of these, 11 (42.3%) opted for primary repair without placement of an IPP. Three (27.2%) of these 11 patients went on to develop ED postoperatively. MAIN OUTCOME MEASURES: We compared various demographic, PDU, and DICC parameters between patients who did and did not fail primary repair of their PD. RESULTS: Mean age and follow-up of patients who went on to develop ED after repair of PD without IPP were not significantly different (P < 0.05). Resistive index (RI) and end diastolic volume were significantly different between these two groups (P < 0.05), while peak systolic volume, flow to maintain, and pressure decay were not significantly different. An RI cutoff of <0.80 was found to identify all patients who would later develop ED and fail primary repair without IPP. CONCLUSIONS: Penile vascular assessment can aid in counseling patients about their risk of developing delayed ED after primary repair of PD. In our cohort of patients, PDU provided preoperative risk stratification for postoperative erectile dysfunction in men undergoing Peyronie's repair without IPP. We propose the prospective study of an RI cutoff to identify patients at risk of failing primary PD repair without IPP.
机译：简介：阴茎血管异常多见于Peyronie病（PD）患者。阴茎双工超声检查（PDU）和动态输注海绵体吸收术和海绵体造影（DICC）是可用于帮助为接受PD手术治疗的患者量身定制个性化治疗的工具。然而，之前尚未阐明哪些参数可用于预测那些在没有充气性阴茎假体（IPP）的干预后有发展为勃起功能障碍（ED）风险的PD患者。目的：评估术前血管参数，这些参数使PD患者在无IPP干预后易于发展为ED。方法：回顾性分析在单个中心接受手术治疗的PD患者26例。其中有11名（42.3％）选择不进行IPP的情况下进行初次维修。这11名患者中有3名（27.2％）在术后继续发展为ED。主要观察指标：我们比较了PD初次修复失败和未失败的患者的各种人口统计学，PDU和DICC参数。结果：没有IPP的PD修复后继续发展ED的患者的平均年龄和随访情况无显着差异（P <0.05）。两组的电阻指数（RI）和舒张末期容积显着不同（P <0.05），而收缩期峰值容积，维持流量和压力衰减无显着差异。发现RI临界值<0.80可以识别出所有后来发展为ED且在没有IPP的情况下一次修复失败的患者。结论：阴茎血管评估可以帮助咨询患者PD初步修复后发展ED延迟的风险。在我们的患者队列中，PDU对没有进行IPP的佩罗尼氏修补术的男性患者术后勃起功能障碍提供了术前危险分层。我们建议进行RI截断的前瞻性研究，以识别没有IPP可能导致PD一级修复失败的患者。

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