Peyronie hastalığının cerrahi tedavisinde Levine’nin önerileri: Greft uygulamaları ve plikasyon tekniği

Year 2016, Volume: 11 Issue: 1, 32 - 37, 01.01.2016

Umut Gülaçtı Uğur Lök Bedrettin Kalyenci Hacı Polat

Abstract

Amaç: Bu çalışmada, üroloji alanındaki nadir cerrahilerden olan peyronie hastalığına niques used for the correction of penile curvabağlı gelişen penil kurvatürlerin düzeltilmesinture due to Peyronie’s disease was investigated. de uygulanan tekniklerden, safen ven grefti ve penil plikasyon tekniğinin başarısı incelendi. Gereç ve Yöntemler: Haziran 2012 ile Mayıs 2014 yılları arasında, Peyronie hastalığı nedeniyle 308 hasta takip ve tedavi edildi. Medikal tedavinin başarısız olduğu 9 hastaya penis düzeltme ameliyatları yapıldı. 45 dereceden fazla Peyronie’s disease between June 2012 and May kurvatürü olan ve erektil kapasitesi normal olan hastalar ameliyata alındı. 2014 were reviewed retrospectively. Bulgular: Penil kurvatür, 4 %44,4 hastada 60 derece ve üzerinde iken 5 %55,6 hastada 45 ile 60 derece arasındaydı. 4 %44,4 hastada insizyon+safen ven grefti, 3 %33,3 hastada on. 1 patient underwent vein graft and plication plikasyon cerrahisi uygulandı. Birer hastada ise in same session and 1 patient underwent dermal ven grefti+plikasyon ile deri grefti+plikasyon graft and plication in same session. Complete uygulandı. 7 %77,8 hastada peniste tam düzflattening of penis was achieved in 7 patients. leşme elde edilirken, ven grefti uygulanan 1 Residual curvature greater than 30 degrees was %11,1 hastada 30 dereceden fazla rezidüel remained in 1 patient that vein graft was applied. kurvatür kaldı. Sonuç: Peyronie hastalığına bağlı penil plication technique can be applied with success in correction of penile curvature due to kurvatürün düzeltilmesinde, greft uygulamaları ve penil plikasyon tekniği başarı ile uygulanabilir. 60 derece ve üzerinde kurvatürü olan hastalarda greft uygulamalarının, daha hafif curvature that more than 60 degrees and penile kurvatürü olan hastalarda ise penil plikasyon plication technique is more suitable in patients tekniğinin daha uygun olduğunu düşünüyoruz

Keywords

Greft , Peyronie hastalığı , plikasyon

Levine’s proposals for the surgical treatment of Peyronie’s disease: Graft applications and plication tech- nique

Abstract

Objectives: In this study, the success of techniques used for the correction of penile curvature due to Peyronie’s disease was investigated. Graft techniques and penile plication technique, which are rare surgeries in urology practise were examined. Material and Methods: Data of nine patients who underwent corrective penile surgery for correction of penile curvature due to Peyronie’s disease between June 2012 and May 2014 were reviewed retrospectively. Results: Penile curvature was over 60 degrees in 4 patients and between 45-60 degrees in 5 patients. 4 patients underwent saphenous vein grafting and 3 patients underwent penile plication. 1 patient underwent vein graft and plication in same session and 1 patient underwent dermal graft and plication in same session. Complete flattening of penis was achieved in 7 patients. Residual curvature greater than 30 degrees was remained in 1 patient that vein graft was applied. Conclusion: Graft applications and penile plication technique can be applied with success in correction of penile curvature due to Peyronie’s disease. We think that graft applications are more suitable in patients with penile curvature that more than 60 degrees and penile plication technique is more suitable in patients with curvature that less than 60 degrees.

Keywords

Graft , Peyronie’s disease , plication

References

• Kumar B, Narang T, Gupta S, Gulati M A clinico-aetiolo- gical and ultrasonographic study of Peyronie’s disease Sex Health 2006;3:113-8.
• La Pera G, Pescatori ES, Calabrese M, Boffini A, Colom- bo F, Andriani E, Taggi F Peyronie’s disease: Prevalence and association with cigarette smoking European urology 2001;40: 525-530.
• Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, Davis R, Hellstrom W. Subjective and objective analysis of the prevalence of Peyronie’s disease in a popu- lation of men presenting for prostate cancer screening. J Urol 2004;171:2350-3.
• Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath, B, Engelmann U. The prevalence of Peyronie’s disease: results of a large survey BJU international 2001;88: 727-730 .
• Arafa M, Eid H, El-Badry A, Ezz-Eldine K, Shamloul, R. The prevalence of Peyronie’s disease in diabetic patients with erectile dysfunction. International journal of impo- tence research 2007;19: 213-217 .
• Charles Jr J, Somers KD, Jordan GH, Schlossberg SM. Pro- posal: trauma as the cause of the Peyronie’s lesion The Jo- urnal of urology 1997; 157: 285-290 .
• Gholami SS, Gonzalez-Cadavid NF, Lin CS, Rajfer J, Lue TF. Peyronie’s disease: a review. J Urol 2003;169: 1234– 1241.
• Gholami SS, Lue TF. Peyronie’s disease. Urol Clin North Am 2001; 28: 377-390.
• Hatzimouratidis, K., Eardley, I., Giuliano, F., Hatzichristou, D., Moncada, I., Salonia, A.,& Wespes, E. EAU guidelines on penile curvature.European urology 2012; 62: 543-552.
• Kadıoğlu A, Akman T, Şanlı, Ö, Gürkan L, Çakan M, Çel- tik M,Makaleler B. Peyronie hastalığının cerrahi tedavisi Turkish Journal of Urology 2006; 32; 51-6.
• Ralph DJ, Al-Akraa M, Pryor JP. Nesbit Operation for Peyronie’s Disease: 16-Year Experience The Journal of uro- logy 1995;154: 1362-1363 .
• Savoca G, Trombetta C, Ciampalini S, De Stefani S, Buttaz- zi L, Belgrano E.Long-term results with Nesbit’s procedure as treatment of Peyronie’s disease International journal of impotence research 2000;12: 289-293.
• Bokarica, P, Parazajder, J, Mazuran, B, Gilja, I. Surgical treatment of Peyronie’s disease based on penile length and degree of curvature International journal of impotence re- search 2005; 17: 170-174 .
• Cormio L, Zucchi A, Lorusso F, Selvaggio O, Fioretti F, Po- rena M, Carrieri G. Surgical treatment of Peyronie’s disease by plaque incision and grafting with buccal mucosa Euro- pean urology 2009; 55: 1469-1476 .
• Kadioglu A, Akman T, Sanli O, Gurkan L, Cakan M, Celtik M. Surgical treatment of Peyronie’s disease: a critical analy- sis European urology 2006;50; 235-248.
• Chung E, Clendinning E, Lessard L, Brock G. Five‐Year Follow‐Up of Peyronie’s Graft Surgery: Outcomes and Pa- tient Satisfaction The journal of sexual medicine 2011; 8: 594-600.