颊粘膜替代斑块治疗阴茎硬结症(附27例报告)

Replacement of Plaque by Buccal Mucosa in the Treatment of Peyronie's Disease:A Report of 27 Cases

目的:评价使用颊粘膜替代阴茎斑块治疗阴茎硬结症的临床效果。方法:27例阴茎硬结症患者,年龄24～72岁,平均53岁,病程1～13年,勃起时阴茎弯曲的角度为30～80度。阴茎硬结位于阴茎背侧根部15例,阴茎背侧中部6例,阴茎冠状沟下3例,阴茎腹侧中部3例。硬结数目:1枚24例,2枚2例,3枚1例。硬结大小:0.7cm×0.7cm～1.6cm×1.0cm,采用手术切除阴茎海绵体白膜斑块,自体颊粘膜移植物替代治疗,并进行随访。结果:本组27例患者矫形满意,口腔疼痛多在1周内消失。3例面颊部水肿明显,5～7d后消失。无血肿、感染、口腔麻木及张口紧缩感。24例获得随访,随访6个月～7年,平均31个月,21例患者阴茎伸直,3例稍有弯曲,弯曲角度<15度,不影响阴茎有效勃起及正常性生活,无阴茎缩窄及凹痕感,无局部阴茎白膜膨出,2例阴茎长度术后有缩短(<1cm),3例仍有阴茎勃起疼痛。结论:颊粘膜弹性好,不挛缩,可在男科治疗阴茎硬结症中广泛使用。

Objective： To evaluate the clinical results of the replacement of plaque by buccal mucosa in the treatment of Peyronie＇s disease. Methods ： We performed surgical replacement of the plaque by free autograft of buccal mucosa on 27 patients with Peyronie＇s disease, ranging in age from 24 to 72 years （ mean 53 ） , varying in disease course between 1 and 13 years, with a penile curvature angle of 30° - 80° in erection. Of the total number, 15 patients had the plaque located in the dorsal root, 6 in the dorsal shaft, 3 in the subcoronal shaft and 3 in the ventral shaft of the penis ; 24 had 1 plaque, 2 had 2 and 1 had 3, ranging in size from 0.7 cm × 0.7 cm to 1.6 cm× 1.0 cm. Results ： Satisfactory results were achieved in all the cases, with no such complications as hematoma, infection, oral numbness, and tightness of the mouth. Of the 24 cases that were followed up for 0.5 to 7 years, complete straightening of the penis was achieved in 21, slight residual curvature （ 〈 15°） was noted in 3, a little shortening of the penis （ 〈 1 cm） in 2, and erectile pain in 3. Conclusion ： Buccal mucosa, with a stable elasticity and no shrinkage, can be recommended for wide use in the surgical treatment of Peyronie＇s disease.