体外冲击波与自体睾丸鞘膜移植术治疗阴茎硬结症的效果比较

Comparison of efficacy of extracorporeal shockwave and autologous perididymal patch grafting for Peyronie's disease

目的比较分析经体外冲击波与自体睾丸鞘膜移植术两组治疗方式对阴茎硬结症的临床效果。方法选取2010年6月～2016年1月徐州市中心医院收治的20例诊断阴茎硬结症的患者,按照随机数法分为对照组和观察组,每组各10例。对照组行体外冲击波治疗,观察组行自体睾丸鞘膜移植术。比较两组治疗前后国际勃起功能指数(IIEF-5)、硬结大小及阴茎弯曲度。结果对照组治疗前后IIEF-5评分、硬结大小及阴茎弯曲度比较,差异无统计学意义(P> 0.05)。治疗后观察组IIEF-5评分较治疗前明显升高,差异有统计学意义(P <0.05);硬结在治疗后消失,治疗前后硬结大小比较,差异有统计学意义(P <0.05);治疗后阴茎弯曲度低于治疗前,差异有统计学意义(P <0.05)。两组治疗后的IIEF-5评分、硬结大小及阴茎弯曲度比较,差异均有统计学意义(P <0.05)。结论体外冲击波治疗阴茎硬结症的效果仍存在疑议,自体睾丸鞘膜移植术是治疗阴茎硬结症安全有效的手术方式。

Objective To compare and analyze the clinical efficacy of extracorporeal shockwave and autologous perididymal patch grafting for Peyronie′s disease. Methods From June 2010 to January 2016, in Xuzhou Central Hospital, l20 patients with Peyronie′s disease were selected, according to the random number method, they were divided into control group and observation group, with 10 cases in each group. The control group was treated with extracorporeal shock wave, and the observation group was treated with autologous perididymal patch grafting. The international index of erectile function-5 （IIEF-5）, penile curvature between the two groups before and after treatment were compared and analyzed. Results The IIEF-5 score, induration size and penile curvature before and after treatment in control group were compared, the differences were not statistically significant （P 〉 0.05）. After treatment, in the observation group, the IIEF-5 score was significantly higher than that before the treatment, the difference was statistically significant （P 〈 0.05）; penile induration was no recurrence after treatment, the size of penile induration before and after treatment was compared, and the difference was statistically significant （P 〈 0.05）; the penile curvature after treatment was lower than that before treatment, the difference was statistically significant （P 〈 0.05）. The IIEF-5 score, induration size and penile curvature in the two groups after treatment were compared, the differences were statistically significant （P 〈 0.05）. Conclusion The efficacy of extracorporeal shock wave therapy for penile induration is still doubtful. Autologous perididymal patch grafting is a safe and effective surgical method for the treatment of Peyronie′s disease.