可膨胀阴茎假体植入手术治疗勃起功能障碍的系统性回顾与荟萃分析

Surgical treatment of erectile dysfunction with inflatable pe nile prosthesis:a systematic review and Metaanalysis

目的对可膨胀阴茎假体(IPP)植入手术治疗勃起功能障碍(ED)的有效性和安全性进行系统评价。方法通过系统检索PubMed、Embase、Cochrane、万方数据库、中国知网和维普数据库,纳入有关IPP植入手术治疗ED的临床研究,使用Comprehensive Meta-Analysis V3(CMA,Biostat)软件进行荟萃分析,评估该手术技术治疗ED后的满意率及并发症发生情况。结果分析涵盖了537篇文献,最终有20篇文献符合纳入标准,总患者数2314例。荟萃分析结果显示术后患者满意率为89.7%(95%CI:86.4%~92.3%,I^(2)=60.635%),总并发症发生率为12.7%(95%CI:8.7%~18.1%,I^(2)=85.185%),假体总取出或翻修率为8.6%(95%CI:6.1%~12.1%,I^(2)=67.771%)。结论IPP植入手术治疗ED具有很好的有效性和安全性,是一线、二线治疗无效的重症ED患者理想的治疗方式。但受限于技术特点,患者术后近期内有需要再次手术的可能。

Objective To systematically evaluate the fficacy and safety of inflatable penile prosthesis(IPP)for surgical treatment of erectile dysfunction(ED).Methods PubMed,Embase,Cochrane,Wanfang Database,CNKI,VIP database were systematically searched to include clinical studies on the surgical treatment of ED with IPP implantation.Comprehensive Meta analysis V3(CMA,Biostat)was used to conduct Meta-analysis,and to assess satisfaction after this ED surgical treatment and the occurrence of complication.Results The analysis included 537 articles,of which 20 met the inclusion critenia,with a total of 2,314 patients.Meta-analysis showed that postoperative satisfaction mate was 89.7%(95%CI:86.4%-92.3%,I^(2)=60.635%),and the total complication mate was 12.7%(95%CI:8.7%-18.1%,I^(2)=85.185%),the total removal or revision rate of prosthesis was 8.6%(95%CI:6.1%-12.1%,I^(2)=67.771%).Conclusions IPP implantation has good efficacy and safety in the treatment of ED,and is an ideal treatment for severe ED patients who have failed first-line and second-line treatment.However,due to the technical characteristics,the patient may need reoperation in the near future after implantation.