Urology · 2019
A Comparison of Hemostatic Patches Versus Pericardium Allograft for the Treatment of Complex Peyronie's Disease With Penile Prosthesis and Plaque Incision.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Farrell M Ryan, Abdelsayed George A, Ziegelmann Matthew J, Levine Laurence A
Аннотация
OBJECTIVE: To compare outcomes between hemostatic patches (HP) versus pericardium allografts (PA) for complex Peyronie's disease with erectile dysfunction managed with inflatable penile prosthesis (IPP) and plaque incision and grafting (PIG).
METHODS: We reviewed all men who underwent IPP with PIG for PD at our institution (4/2010-9/2018). PIG was performed via relaxing tunical incisions during IPP implantation following manual modeling if there was persistent curve >30° and/or significant narrowing. Tunical defects >2 cm were grafted. PA (Coloplast, Minneapolis, MN) or HP consisting of either Evarrest, Nu-Knit (Ethicon Inc., Somerville, NJ), or TachoSil (Baxter Int., Deerfield, IL) were used.
RESULTS: HP was placed in 18 men (n = 10 Evarrest, n = 6 Nu-Knit, and n = 2 TachoSil), 15 had PA. There was no difference in mean age, preoperative curvature (HP:75° vs PA:78°), or grafted area (HP:11.9 cm2 vs PA:10.9 cm2) between HP and PA cohorts. Mean operative time was shorter for HP (122 vs 166 minutes, P = .01). Median follow-up: 6.6 months (range: 2-27 months) for HP and 34.6 months (range: 13-103 months) for PA. Residual curvature >20° was present following HP in 16.7% (n = 3) and PA in 13.3% (n = 2; P = 1.0). There were no complications attributable to HP/PA material and no IPP herniation through the tunical defect. Postoperatively, 94.4% (n = 17) of HP and 93.3% (n = 14) of PA patients were engaged in penetrative intercourse (P = 1.0).
CONCLUSION: HP are effective materials to cover the tunical defect over an IPP following plaque incision for PD. HP outcomes are similar to PA, while operative time is shorter for HP.
METHODS: We reviewed all men who underwent IPP with PIG for PD at our institution (4/2010-9/2018). PIG was performed via relaxing tunical incisions during IPP implantation following manual modeling if there was persistent curve >30° and/or significant narrowing. Tunical defects >2 cm were grafted. PA (Coloplast, Minneapolis, MN) or HP consisting of either Evarrest, Nu-Knit (Ethicon Inc., Somerville, NJ), or TachoSil (Baxter Int., Deerfield, IL) were used.
RESULTS: HP was placed in 18 men (n = 10 Evarrest, n = 6 Nu-Knit, and n = 2 TachoSil), 15 had PA. There was no difference in mean age, preoperative curvature (HP:75° vs PA:78°), or grafted area (HP:11.9 cm2 vs PA:10.9 cm2) between HP and PA cohorts. Mean operative time was shorter for HP (122 vs 166 minutes, P = .01). Median follow-up: 6.6 months (range: 2-27 months) for HP and 34.6 months (range: 13-103 months) for PA. Residual curvature >20° was present following HP in 16.7% (n = 3) and PA in 13.3% (n = 2; P = 1.0). There were no complications attributable to HP/PA material and no IPP herniation through the tunical defect. Postoperatively, 94.4% (n = 17) of HP and 93.3% (n = 14) of PA patients were engaged in penetrative intercourse (P = 1.0).
CONCLUSION: HP are effective materials to cover the tunical defect over an IPP following plaque incision for PD. HP outcomes are similar to PA, while operative time is shorter for HP.