İki olgu eşliğinde Peyronie hastalığının cerrahi tedavisinde penil plikasyon yöntemlerinin değerlendirilmesi

Peyronie hastalığı peniste ağrı, penil kurvatür ve erektil disfonksiyona (ED) neden olan,tunika albugineanın fibroblast proliferasyonunun neden olduğu fibröz plak oluşumuyla karakterize inflamatuar bir süreçtir. Tanımlanan medikal tedavi alternatifleriyle az sayıda prospektif kontrollü çalışmada anlamlı klinik etkinlik ortaya konabilimiştir.Cerrahi tedaviler (penil plikasyon, Nesbit plikasyonu, plak insizyonu ve greft ve penil protez implantasyonu) Peyronie hastalığı stabilleştikten sonra önerilmelidir. Cerrahi tedavi sonuçlarının incelendiği çalışmalarda stabil dönemdeki deformitelerin Nesbit prosedürüyle başarıyla düzeltildiği ve bu yöntemde postoperatif ED’nin en düşük olduğu gösterilmiştir. Plak insizyonu ve greftleme yöntemi, postoperatif ED oranı yüksek olsa da belirgin penis kısalığı bulunan ve erektil fonksiyon kalitesi iyi olan hastalarda önerilmelidir. Erektil disfonksiyonu olan hastalarda ise en uygun seçenek penil protez implantasyonudur. Bu yazımızda iki olgunun sunumu eşliğinde Peyronie hastalığında penil plikasyon yöntemleri değerlendirilmiştir.

Analysis of penile plicaiıon methods in the surgical treatment of Peyronie disease with the presentation of two cases

Peyronie’s disease is characterized by an inflammatory response beneath the tunica albuginea with fibroblast proliferation forming a thickened fibrous plaque that may cause penile pain, penile curvature and erectile dysfunction (ED). Medical treatments have been described but few prospective controlled trials have revealed significant clinical benefits. Surgical treatments (penile plication, Nesbit plication, plaque incision and grafting and penile prosthesis insertion) should be considered after Peyronie’s disease has stabilized. Surgical outcome studies reveal that a stable deformity is best corrected with the least postoperative ED by a Nesbit procedure. Plaque incision and grafting should be reserved for men with good erectile function and marked penile shortening although there is a higher prevalence of postoperative ED. Implantation of a penile prosthesis is an excellent option for men with an accompanying erectile deficit. The present article reviews the penile plication methods for the surgical alternatives of Peyronie’s disease with the presantation of two cases.

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Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1300-6622
  • Yayın Aralığı: Yıllık
  • Başlangıç: 2015
  • Yayıncı: -