用小的轻型轴向假体（VIRILIS I）和牛围心移植物（HYDRIX）进行佩罗尼氏症患者的海绵体整形术

Corporoplasty with small soft axial prostheses （VIRILIS ） and bovine pericardial graft （HYDRIX） in Peyronie＇s disease

Austoni和Egydio开创的治疗佩罗尼氏症的手术方法主要基于几何学原理。本文主要报道我们对Austoni方法进行的改进以及我们的多中心经验，同时提供一些技巧和要决，使得该方法操作起来更容易。手术在意大利的三个研究所分别进行。我们用牛围心胶原基质片（Hydrix）植入了小的轻型轴向假休（VIRILlS I，Ф7Fr．）以遮盖白膜上的损伤。行此手术的患者为2005年9月到2010年1月间的60名患者，平均年龄为58岁（范围：44—76岁）。术后，轴平均伸长了2cm（range 1．2-2_3cm），阴茎的反屈畸形完全被修复了。39名患者的性功能存60天后恢复．14名在90天后，7名在120天后。IIEF分值术前为15．5，术后12个月和24个月后，升高到23。与自然性交（80％以上的夫妇）和阴茎自然长发和围长有关的VAS分值结果也非常好。这种轻型移植物主要是植入自然勃起时的海绵体组织的少量空间。这种方法简单易学易操作，心包膜的使用也加快了手术速度，因复杂的反心畸形而引起的包膜损伤也被修复了。

The surgical techniques used by Austoni and Egydio in the treatment of Peyronie＇s disease are based on geometric principles. The aim of this paper is to report our multicentric experience and technical changes to Austoni＇s original technique, focusing on several tips and tricks to make this technique easy to perform, even by less experienced practitioners. We performed operations in three different Italian institutions. We implanted a small soft Virilis I~ axial prostheses （Ф 7 Fr.）, using a bovine pericardium collagen matrix patch （Hydrix） to cover the defect in the tunica albuginea. Sixty patients with a mean age of 58 years （range 44-76 years） underwent surgery between September 2005 and January 2010. After surgery, mean lengthening of the shaft was 2 cm （range 1.2-2.3 cm） with complete correction of penile recurvatum. Thirty-nine patients resumed sexual activity 60 days later, 14 after 90 days and 7 after 120 days. The international index of erectile function （IIEF） score was 15.5 before surgery and it improved to 23 at 12 and 24 months after surgery. Furthermore, the visual analogue scale （VAS） showed good results in terms of the recovery of natural sexual intercourse （over 80% of couples） and of the original length and girth of the penis. The soft implant we used takes advantage of erection that occurs spontaneously, using the residual erection of the spared cavernous tissue. The method is easy to learn and reproducible, and the use of pericardium speeds up the operation, while also covering large defects of the tunica albuginea that result from complex recurvatum.