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Management of Peyronie's Disease by Dermal Grafting
oleh: Hamid Reza Nasseh, Hooman Jaladat, GH Pourmand, Abdolrasoul Mehrsai, Mohammad Reza Nikoobakht
Format: | Article |
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Diterbitkan: | Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences 2004-06-01 |
Deskripsi
<p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA">Purpose:</span></strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA"> To evaluate the results of plaque excision and dermal grafting in Peyronie’s disease.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA">Materials and Methods:</span></strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA"> Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie’s disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF) by interviewing the patients and filling questionnaires by their partners. Doppler ultrasonography was used to determine the vascular competence of penis before and after operation in 15 patients. </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA">Results:</span></strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA"> The disease was more prevalent between the ages of 40 and 60 years. Plaques were located as follows: dorsal in 18, right lateral in 6 and left lateral in 3. Mean plaque size was 11 (range 5 to 18) mm. After plaque excision and dermal grafting, penile deformity, erectile dysfunction, and painful erection had remained yet in 4 (15%) out of 27, 3 (16%) out of 19, and 3 (14%) out of 22, respectively. Doppler ultrasonographic study in 15 patients revealed improvement in peak systolic velocity (P < 0.01). In addition, a decrease in end diastolic velocity was noted also that was not significant statistically (P = 0.26). Resistive index did not improve after operation.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-ansi-language: EN-CA;" lang="EN-CA">Conclusion:</span></strong><em><span style="mso-ansi-language: EN-CA;" lang="EN-CA"> </span></em><span style="mso-ansi-language: EN-CA;" lang="EN-CA">This procedure showed significant improvement in penile deformity (85% of cases), erectile dysfunction (84% of cases) and painful erection (86% of cases). We recommend plaque excision and dermal grafting as an effective procedure in treating Peyronie’s disease.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="mso-ansi-language: EN-CA;" lang="EN-CA"><span style="font-size: small; font-family: Times New Roman;"> </span></span></p>