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Tunica albuginea allograft： a new model of LaPeyronie＇s disease with penile curvature and subtunical ossification

Asian Journal of Andrology 2014年第4期16卷 592-596页

作者： Ludovic Ferretti Thomas M Fandel Xuefeng Qiu Haiyang Zhang Hazem Orabi Alex K Wu Lia Banie Guifang Wang Guiting Lin Ching-Shwun Lin Tom FLue Department of Urology University of Bordeaux Bordeaux France Department of Urology Knuppe Molecular Urology Laboratory University of California San Francisco San Francisco California USA Hospital d'lnstruction des Armees Robert Picque Villenave D'Ornon France 4Department of Urology Assiut University Assiut Egypt. Department of Urology Assiut University Assiut Egypt.

The pathophysiology of LaPeyronie＇s disease （PD） is considered to be multifactorial, involving genetic predisposition, trauma, inflammation and altered wound healing. However, these factors have not yet been validated using animal models. In this study, we have presented a new model obtained by tunica albuginea allograft. A total of 40, 16-week-old male rats were used. Of these, 8 rats served as controls and underwent a 10 × 2-mm-wide tunical excisionwith subsequent autografting, whereas the remaining 32 underwent the same excision with grafting of the defect with another rat＇s tunica. Morphological and functional testing was performed at 1, 3, 7 and 12 weeks after grafting. Intracavernous pressure, the degree of penile curvature and elastic fiber length were evaluated for comparison between the allograft and control groups. The tissues were obtained for histological examination. The penile curvature was significantly greater in the allografted rats as compared with the control rats. The erectile function was maintained in all rats, except in those assessed at 12 weeks. The elastin fiber length was decreased in the allografted tunica as compared to control. SMAD2 expression was detected in the inner part of the allograff, and both collagen-Ⅱ- and osteocalcin-positive cells were also noted. Tunica albuginea （TA） allograft in rats is an excellent model of PD. The persistence of curvature beyond 12 weeks and the presence of ossification in the inner layer of the TA were similar to those observed in men with PD. Validation studies using this animal model would aid understanding of the PD pathophysiology for effective therapeutic interventions.

关键词： allograft animal model osteogenesis penile curvature penile surgery peyronie's disease

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Management of residual penile curvature after penile prosthesis placement

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Asian Journal of Andrology 2021年第2期23卷 129-134页

作者： Denis V Krakhotkin David J Ralph Gideon A Blecher Volodymyr A Chernylovskyi Francesco Greco Evgeny E Bakurov Ruslan A Bugaev Central District Hospital Outpatient DepartmentKamenolomniRostov Region 346480Russia University College London St Peter’s Andrology Centre and University College London Hospitals London W1G 6BJUnited Kingdom Monash University Department of SurgeryMelbourne 3168Australia The Alfred Hospital Department of UrologyMelbourne 3004Australia Department of Urology 1 City Clinical Hospital No.4Dnipro 49102Ukraine Department of Urology Humanitas GavazzeniBergamo 24125Italy Department of Surgery No.1 Rostov Regional Hospital ROKB 1Rostov-on-Don 344015Russia

Residual penile curvature is a common situation following the implantation of a penile prosthesis in patients with Peyronie’s ***,there is a variety of options for the correction of residual curvature,including penile modeling,plication techniques,as well as tunical incision/excision with or without grafting.A literature search of PubMed and Medline databases was conducted from 1964 until 2020,using search terms for all articles in the English *** this article,we provide a review of the techniques and the outcomes,according to the published literature.

关键词： grafting modeling penile curvature penile implant penile prosthesis Peyronie’s disease tunical plication

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Congenital penile curvature: long-term results of operative treatment using the plication procedure

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Asian Journal of Andrology 2004年第3期6卷 273-276页

作者： S.-S.Lee E.Meng F.-P.Chuang C.-Y.Yen S.-Y.Chang D.-S.Yu G.-H.Sun Division of Urology Department of SurgeryTri-Service General HospitalNational Defense Medical CenterNationalDefense UniversityTaipeiChina

Aim: To determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea. Methods: From January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients. Results: penile straightening was excellent in 62 patients (91 %) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51 %) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied. Conclusion: Corporeal plication is an effective and durable procedure with a high rate of patient satisfaction.

关键词： penile curvature treatment plication procedure

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Effects of patients'understanding and choice of surgical types on postoperative outcomes of Peyronie’s disease:a single-center retrospective study of 108 patients

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Asian Journal of Andrology 2021年第5期23卷 484-489页

作者： Da-Chao Zheng Jie-Wen Bao Jian-Hua Guo Min-Kai Xie Wen Ji Li Zhong Wang Department of Urology and Andrology Ninth People's HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200011China

Surgical correction can be considered for treating patients with a chronic phase of Peyronie’s disease(PD)and persistent penile *** clinical practice,some patients pay too much attention to surgical complications and refuse the recommended feasible surgical ***,they require operations according to their *** study aimed to evaluate the effects of patients’own choice of surgical type on postoperative *** retrospective study analyzed data from 108 patients with PD who underwent surgical correction according to doctors’recommendations or patients’own *** objective and subjective surgical outcomes were ***1 understanding of the disease was analyzed using a questionnaire *** measurements of surgical outcomes,including penile straightening,penile length,and sexual function,in patients who received the recommended surgery,were similar to those in patients who did not accept the recommended ***,subjective evaluations,including erectile pain,discomfort because of nodules on the penis,and decreased sensitivity in the penis,were more obvious in patients who did not follow doctors’*** addition,a questionnaire survey showed that understanding PD and the purpose of surgery of patients who did not follow doctors’advice were inappropriate,as they did not conform to the principle of *** present study showed that surgical correction seemed to be an objectively effective option in the management of patients in the stable chronic phase of *** patient satisfaction might be related to patients’lack of correct understanding of the disease and its treatment strategy as well as unrealistic expectations.

关键词： grafting procedure patient’s satisfaction penile curvature Peyronie’s disease plication

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Effects of plication procedures in special cases of Peyronie’s disease:a single-center retrospective study of 72 patients

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Asian Journal of Andrology 2022年第3期24卷 294-298页

作者： Wen Ji Li Jie-Wen Bao Jian-Hua Guo Da-Chao Zheng Min-Kai Xie Zhong Wang Department of Urology and Andrology Ninth People’s HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200011China

General recommendations regarding surgical techniques are not always appropriate for all Peyronie’s disease(PD)***,the purpose of this study was to investigate the effects of plication procedures in PD patients with severe penile curvature and the effects of early surgical correction in patients who no longer have progressive *** clinical data from 72 patients who underwent plication procedures were analyzed in this *** were divided into Groups A and B according to the curvature severity(≤60°or>60°)and Groups 1 and 2 according to the duration of disease stabilization(≥3 months orpenile straightening,and 60.0%(24/40)and 100.0%(32/32)patients reported penile shortening in Groups A and B,*** curvature recurrence occurred in any patient,and no significant differences were observed in postoperative International Index of Erectile Function–Erectile Function domain(IIEF-EF),erectile pain,sensitivity,or suture knots on the penis whether such outcomes were grouped according to the curvature severity or the duration of ***,the duration from symptom onset to surgical management in Group 1 was significantly longer than that in Group 2(mean±standard deviation[s.d.]:20.9±2.0 months and 14.3±1.2 months,respectively,Ppenile *** addition,the early surgical treatment seemed to benefit those patients who already had no erectile pain and no longer exhibited progressive deformity.

关键词： penile curvature Peyronie’s disease plication

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Grafts in Peyronie’s surgery without the use of prostheses:a systematic review and meta-analysis

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Asian Journal of Andrology 2024年第3期26卷 250-259页

作者： Anastasios Natsos Vasileios Tatanis Stavros Kontogiannis Sharon Waisbrod Kristiana Gkeka Mohamed Obaidad Angelis Peteinaris Konstantinos Pagonis Costas Papadopoulos Panagiotis Kallidonis Evangelos Liatsikos Petros Drettas Department of Urology University of PatrasPatras 26500Greece Uroclinic Pfaeffikon 8808Switzerland Department of Medical Physics University of PatrasPatras26500Greece Department of Urology Medical University of ViennaVienna 1090Austria

Peyronie’s disease(PD)is characterized by abnormal penile curvature,and various surgical methods have been developed usingdifferent graft ***,there is currently no universal agreement on which type of graft is the *** objective of thisreview was to evaluate the available literature and identify the most effective graft material for penile curvature correction in PD.A literature search was conducted using electronic databases,including PubMed,Scopus,and the Cochrane *** patients,intervention,comparison,and outcome(PICO)approach was used to define the eligibility of *** authors independentlyselected studies,evaluated them,and extracted ***-effect models using the DerSimonian–Laird method were *** were single-arm studies and had a high risk of *** mucosa grafts(BMG)were found to result in the highest penilestraightening rates and were associated with the least de novo erectile *** grafts demonstrated a high successrate in straightening despite a higher mean preoperative curvature,while Tutoplast grafts had a higher incidence of postoperativeerectile *** had the highest percentage of postoperative penile ***,the TachoSil graft showed thebest performance when preoperative curvature is taken into *** on the available literature,BMG appear to be the mosteffective for penile curvature correction in PD,but this is offset by the requirement for low preoperative *** TachoSilgraft shows the best overall performance when preoperative curvature is *** randomized clinical trials arestill needed to determine graft superiority.

关键词： erectile function penile curvature penile grafts Peyronie’s disease

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A novel onlay urethroplasty for hypospadias with mild chordee after degloving:modified for complete removal of scar tissue underlying the urethral plate and for long-term outcomes

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Asian Journal of Andrology 2022年第6期24卷 639-642页

作者： Li-Qu Huang Zheng Ge Li-Xia Wang Xiao-Yu Li Yong-Ji Deng Yun-Fei Guo Geng Ma Department of Urology Children's Hospital of Nanjing Medical UniversityJiangsu Provincial Children's Medical CenterNanjing 210008China

Urethral plate(UP)-preserving urethroplasty is simple and has few complications,but it may affect the development of penis in the long term and lead to recurrent *** this study,we used obliquely cut UP to repair hypospadias with mild chordee after degloving(15°-30°)and compared the results with onlay urethroplasty to explore its rationality and *** April 2018 and October 2020,108 hypospadias patients underwent onlay urethroplasty or modified onlay *** data were prospectively collected,and medium-term outcomes were assessed at *** complications were compared between the two ***-four patients underwent the modified onlay procedure(GroupⅠ),with follow-up time(mean±standard deviation[s.d.])of 23.2±4.5(range:17-31)***-four patients underwent a standard onlay procedure(GroupⅡ),with follow-up time(mean±s.d.)of 39.7±3.9(range:32-46)*** was no difference in age at *** urethral defect length and operative time were longer in GroupⅠ.Six cases of fistula and one case each of stricture and diverticulum were reported in GroupⅠ.In GroupⅡ,11 cases of fistula and one case each of stricture and diverticulum were *** complication rates were 18.2%and 20.3%in GroupⅠand GroupⅡ,respectively(P>0.05).These medium-term follow-up results demonstrate that the modified onlay procedure(oblique cut UP urethroplasty)is a safe and feasible technique for hypospadias with mild chordee after *** with standard onlay urethroplasty,this modified procedure is conducive to the complete removal of scar tissue underlying the UP without increasing the risk of surgical complications.

关键词： complications hypospadias penile curvature urethral plate

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Use of a lyophilized bovine pericardium graft to repair tunical defect in patients with Peyronie＇s disease： experience in a clinical setting

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Asian Journal of Andrology 2017年第3期19卷 316-320页

作者： Javier Romero Otero Borja Garcia Gomez Jose Medina Polo Carlos Pascual Mateoe Silvia Garcia Barreras Eduard Garcia Cruz Javier de la Riva de la Vifia Alfredo Rodriguez Antolin 12 de Octubre University Hospital Department of Urology Madrid Spain Monteprincipe University Hospital Department of Urology Madrid Spain Clinic Hospital Department of Urology Barcelona Spain

Many different materials are available for grafting during surgery for Peyronie＇s disease （PD）. To study the outcomes associated with the use of a lyophilized bovine pericardium graft （Peri-Guard） to repair tunical defects in patients with PD, descriptive study of 43 patients with disabling penile curvature was performed. curvature was measured before and after the intervention using a standardized procedure. Surgical technique was plaque excision and grafting of the tunical defect carried out by a single surgeon. A lyophilized bovine pericardium patch was used for grafting. We measured the change in penile curvature and length, the ability to perform successful sexual intercourse without further pharmacological or surgical treatment, and the satisfaction with treatment. Follow-up data were available for a total of 41 patients. Median age was 50 years （IQR 48-52）; mean follow-up time was 14 ± 6 months. Complete penile straightening was achieved in 33 patients （80.5%） and five patients （12.2%） had curvature under 20. Three months after surgery and stretching therapy, mean （s.d.） flaccid penile length increased from 11.2 ± 2.8 cm to 12.1 ± 2.9 cm （P = 0.062）. Seventy-five percentage of patients reported being able to achieve successful intercourse without further treatment. Eighty-five percentage of patients reported to be satisfied with the treatment. There was no evidence of tissue rejection or infection, and only four patients suffered an adverse event. Plaque excision and grafting of the tunical defect with lyophilized bovine pericardium seems to be a safe and effective treatment for patients with PD.

关键词： penile curvature pericardium patch Peyronie's disease surgical treatment

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Extracorporeal shockwave therapy for Peyronie＇s disease： an alternative treatment？

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Asian Journal of Andrology 2006年第A3期8卷 361-366页

作者： Vassilis Poulakis Konstantinos Skriapas Rachelle de Vries Wolfgang Dillenburg Nikolaos Ferakis Ulrich Witzsch Michael Melekos Edward Becht Departments of Urology and Pediatric Urology Nordwest Krankenhaus Stiflung Hospital zum Heiligen GeistFrankfurt am Main D-60488 Germany Department of Urology University Hospital of Larissa Larisa Greece

Aim： To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy （ESWT） in patients with Peyronie＇s disease. Methods： Fifty-three patients with stable Peyronie＇s disease underwent ESWT （group 1）. Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control （group 2）. The patients＇ erectile function （International Index of Erectile Function [IIEF-5] score）, pain severity （visual analog scale）, plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. Results： The mean follow-up time was 32 months （range： 6-64 months） in group 1 and 35 months （range： 9-48 months） in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes （P 〉 0.05） were observed in group 1 before or after the ESWT. A total of 39 patients （74%） reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients （40%） of group 1, the deviation angle was decreased more than 10° with a mean reduction in all patients of 11° （range： 6-20°）. No serious complications were noted considering ESWT procedure. Conclusion： ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie＇s disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable.

关键词： erectile dysfunction extracorporeal shockwave therapy Peyronie's disease penile curvature

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New insights into the pathogenesis of Peyronie’s disease:A narrative review

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Chronic Diseases and Translational Medicine 2020年第3期6卷 165-181页

作者： Denis V.Krakhotkin Volodymyr A.Chernylovskyi Alexandre Mottrie Francesco Greco Ruslan A.Bugaev Outpatient Department Central District HospitalKamenolomniRostov Region.Russia Department of Urology 1 City Clinical Hospital No-4DniproUkraine Department of Urology Onze Li eve Vrouw HospitalAalstBelgium ORSI Academy Me lieBelgium Department of Urology Humanitas GcivazzeniBergamoItaly

Peyronie’s disease(PD)is a benign,progressive fibrotic disorder characterized by scar or plaques within the tunica albuginea(TA)of the *** study provides new insights into the pathogenesis of PD based on data from different studies regarding the roles of cytokines,cell signaling pathways,biochemical mechanisms,genetic factors responsible for fibrogenesis.A growing body of literature has shown that PD is a chronically impaired,localized,wound healing process within the TA and the Smith *** is caused by the influence of different pathological stimuli,most often the effects of mechanical stress during sexual intercourse in genetically sensitive individuals with unusual anatomical TA features,imbalanced matrix metalloproteinase/tissue inhibitor of metalloproteinase(MMP/TIMP),and suppressed antioxidant systems during chronic *** intracellular signal cascades are activated during fibrosis along with low expression levels of their negative regulators and transforming growth factor-β1 *** development of multikinase agents with minimal side effects that can block several signal cell pathways would significantly improve fibrosis in PD tissues by acting on common downstream mediators.

关键词： Peyronie’s disease Cell signal pathway penile curvature Myofibroblast Extracellular matrix

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