Ahmet TAHRA, Eyüp Veli KÜÇÜK, Abdurrahman İNKAYA

Peyroni hastalığının hafif ve orta şiddetli kurvatur tedavisinde plikasyon ve greftleme cerrahisi ile sonuçlarımız

AMAÇ: Hafif ve orta şiddetli kurvatur olan (30-75°) Peyronie hastalarında, penil plikasyon ve greft yöntemlerinin karşılaştırılması amaçlandı.GEREÇ VE YÖNTEM: 2010-2016 yılları arasında Peyronie hastalığı (PH) tanısıyla opere edilen tüm hastalar retrospektif olarak incelendi. Kurvatur derecesi 30-75° olan hastalar plikasyon grubu (n=19) ve greftleme cerrahisi grubu (n=16) olarak değerlendirilerek çalışmaya dahil edildi. Kompleks kurvaturu olan hastalar, kum saati deformitesi olanlar, 'menteşe' etkisi görünümü olan hastalar ve ereksiyon problemi nedeniyle penil protez implantasyonu uygulanan hastalar çalışmaya dahil edilmedi. Hastaların preoperatif ve postoperatif 3. ay, 6. ay ve 12. ayda penil uzunlukları ölçümü yapıldı ve ereksiyon durumları IIEF-5 sorgulama formu kullanılarak değerlendirildi. Başarı, 15° veya daha az kurvatur olması ve ek herhangi bir tedavi almadan ilişki kurabilme olarak değerlendirildi.BULGULAR: Hastaların ortalama yaşı 52,6±5,4 idi. Her iki grup yaş ve komorbidite olarak birbirine benzer idi. Kurvatur derecesi plikasyon grubunda 45,2°±12,3° iken greftleme grubunda 50,6°±20,1° idi. Plikasyon grubunda üç hastada (%15,7) rekürrent kurvatur gözlenirken hastaların penil boyunda ortalama 2,1±0,9 cm kısalma gözlendi. IEFF-5 formunda 3,4±1,3 artış gözlendi. İnsizyon ve greftleme grubunda, hastaların %93,7'si operasyondan memnun iken, herhangi bir tedaviye gerek olmadan ilişki kurabilen hasta sayısı 13 idi (%81,2). Hastalardan ikisinde (%12,5) rekürrent kurvatur mevcut idi. IEFF-5 formunda 3,1±1,8 artış gözlendi. Her iki grup karşılaştırıldığında, rekürrens her iki grupta da benzer idi. Ortalama IIEF-5 skorunda, her iki grupta benzer artış gözlendi (p=0,8).SONUÇ: Hafif ve orta şiddetli kurvaturu olan Peyroni hastalarında, uygun hasta seçiminde, plikasyon tedavisi ile insizyon ve greftleme yöntemleri etkin ve güvenilir tedavilerdir

Treatment of Peyronie’s Disease in mild to moderate penile curvature with plication and grafting surgery

OBJECTIVE: It was aimed to compare penile plication and graft methods in patients with mild to moderate curvature (30–75°) in Peyronie’s disease (PD).MATERIAL AND METHODS: All patients with PD and operated between 2010–2016 were retrospectively reviewed. Patients with 30 to 75 degrees of curvature were included in the study as a group of plication (n=19) and another group of grafting surgery (n=16). Patients with complex curvatures, hourglass deformities, ‘hinge’ effect appearance, and patients with penile prosthesis implantation due to erection problems were excluded from study. Penile length measurements were taken preoperatively and postoperatively at 3 months, 6 months, and 12 months, and erectile status was assessed using the IIEF-5 questionnaire. Success was assessed as being 15 degrees and less curvature, and establishing relationships without any additional treatment.RESULTS: The mean age of the patients was 52.6 ± 5.4. Age and comorbidity were similar in both groups. The mean degree of penile curvature was 45.2 ± 12.3 degrees in the plication group and 50.6 ± 20.1 degrees in the graft group. Recurrent curvature was observed in 3 patients (15.7%) in the plication group, whereas on the average 2.1 ± 0.9 cm shortening was observed in penile length of the patients. The mean increase in the IEFF-5 form was 3.4 ± 1.3. In the grafting group, 93.7% of the patients were satisfied with the operation, while the number of patients with whom they were able to establish a relationship without any treatment was 13 (81.2%). Recurrent curvature was present in 2 (12.5%) of the patients. The mean increase in the IEFF-5 form was 3.1±1.8. Recurrence was similar in both groups. Mean IIEF-5 score increase was similar in both groups (p=0.8).CONCLUSION: In patients with mild to moderate curvature, plication therapy and grafting surgery are effective and safe treatments in appropriately selected patients with Peyronie’s disease

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