背景:虽然恶性阴茎疾病的积极非器官保留手术治疗有趋势,目前存在多种保留阴茎的选择,但迄今为止,该领域的功能结局和患者报告结局(PRO)的报道并不理想.
目的:本研究的目的是报告连续一系列患有扁平苔藓硬化(LS)或局部阴茎癌(PC)的患者的全龟头表面置换(TGR)的功能结果和PRO。
方法:从2004年到2018年,一系列连续的患者在三级转诊网络中接受了TGR以管理LS或局部PC。回顾性分析患者的临床记录和手术记录。用Stata12进行统计分析。
结果:使用国际勃起功能指数(IIEF)和国际前列腺症状评分(IPSS)验证问卷记录了泌尿和性结局,而从5项“特设”电话问卷中推断PROs在手术后1年进行。
结果:共纳入37例连续患者。组织学结果显示16例患者的LS,其余21人被诊断为PC。患者出现的最常见原因是局部疼痛(32.4%)。瘙痒(37.8%)和出血(29.7%)。中位随访时间为22(IQR13-77)个月。中位年龄为62岁(IQR55-68)。评估泌尿和性功能的问卷均未显示手术后有任何明显恶化。89.2%的病例完全维持Glans敏感性。94.5%的患者报告对阴茎的美学外观完全满意,并在必要时会考虑再次进行相同的手术。91.9%的患者会向其他人推荐相同的程序。86.4%的患者报告生活质量总体改善。
结论:对于某些良性或恶性阴茎病变病例,TGR应被视为首选治疗方法。
■我们的研究有一些局限性,首先是它的回顾性。此外,尽管是迄今为止最大的系列之一,随访时间有限,缺乏对照组.
结论:TGR是一种极好的手术选择,可确保令人满意的排尿和性功能,以及选定阴茎病变病例的美容。
BACKGROUND: Whilst there is a trend away from aggressive nonorgan sparing surgical treatments for malignant penile disease, a variety of penile preservation options exist but functional outcomes and patient reported outcomes (PROs) in this area are poorly reported to date.
OBJECTIVE: The aim of this study is to report functional outcomes and PROs of total glans resurfacing (TGR) in a consecutive series of patients with lichen sclerosis (LS) or localized penile cancer (PC).
METHODS: From 2004 to 2018 a consecutive series of patients underwent TGR for the management of LS or localized PC in a tertiary referral network. Patient clinical records and operative notes were retrospectively reviewed. Statistical analysis was conducted with Stata 12.
RESULTS: Urinary and sexual outcomes were recorded utilizing both the International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) validated questionnaires while PROs were extrapolated from a 5-item \"ad hoc\" telephone questionnaire administered at 1 year post procedure.
RESULTS: 37 consecutive patients were enrolled. Histology results demonstrated LS in 16 patients, with the remaining 21 having a diagnosis of PC. The most common reasons for patient presentation were local pain (32.4%), pruritus (37.8%) and bleeding (29.7%). Median follow-up was 22 (IQR 13-77) months. Median age was 62 (IQR 55-68).Neither of the questionnaires assessing urinary and sexual function showed any significant deterioration after surgery. Glans sensitivity was fully maintained in 89.2% of cases. 94.5% of patients reported to be fully satisfied with the aesthetic appearance of the penis and would consider undergoing the same procedure again if necessary. 91.9% of patients would recommend the same procedure to someone else. An overall improvement of the quality of life was reported by 86.4% of patients.
CONCLUSIONS: TGR should be considered a treatment of choice for selected cases of benign or malignant penile lesions.
UNASSIGNED: Our study has some limitations, the first being its retrospective nature. Furthermore, despite being one of the largest series to date, follow-up duration is somewhat limited and a control group is lacking.
CONCLUSIONS: TGR represents an excellent surgical option ensuring satisfactory voiding and sexual function, as well as cosmesis for selected cases of penile lesions.