We have previously reported on the use of Tutoplast cadaveric pericardium as an alternative material for grafting the tunica albugineal defect after Peyronie's plaque excision with satisfactory results in 11 patients. We now review long-term outcomes in this cohort of men. Eleven patients with significant penile curvature interfering with sexual intercourse were evaluated after at least 12 months of conservative therapy. All patients underwent pre-operative evaluation, including penile duplex Doppler ultrasound studies. Chemically processed and gamma-irradiated pericardium (Biodynamics International, Parsippany, NJ) was used to graft the cavernosal defect after surgical excision of the penile plaque. Three patients simultaneously underwent placement of penile prostheses secondary to documented erection problems identified at duplex Doppler ultrasound evaluation. The long-term postoperative complications and erectile function were evaluated with a mean follow-up of 30 months (range 25-35 months). All patients reported resolution of penile curvature allowing for normal sexual function after a mean follow-up of the first 14 months. Thirty months after placement of cadaveric pericardium, the three prosthetic patients still reported excellent sexual function. For the eight patients who did not undergo placement of a prosthesis, three with small to medium plaque size (<2 x 5 cm) continued to do well. The remaining five patients with a large plaque size (>2 x 5 cm) did well initially, but later reported difficulty maintaining erection due to venous leakage, thus they are currently using either a vacuum constriction device or an Actis ring. Three out of these five venous leakage patients had ventral plaques; two had dorsal plaques, one of significant size (4 x 5 cm). We conclude that for those patients who do not undergo placement of a prosthesis, a better long-term outcome is observed when the plaque is small to medium in size (<2 x 5 cm) and dorsally located. Patients with ventral plaque, extreme curvature, or plaque size >4 x 5 cm were more likely to have venoocclusive dysfunction, necessitating further intervention.

中文翻译：

---

在佩罗尼氏病的外科治疗中使用心包移植物的长期随访。

我们以前曾报道过使用Tutoplast尸体心包膜作为替代材料，在Peyronie斑块切除后移植中膜白膜缺损，在11例患者中取得了令人满意的结果。现在，我们回顾这一队列研究中的长期结果。保守治疗至少12个月后评估了11例阴茎弯曲严重，性交障碍的患者。所有患者均接受术前评估，包括阴茎双工多普勒超声研究。经过化学处理和伽马射线照射的心包膜（Biodynamics International，Parsippany，NJ）用于在手术切除阴茎斑块后移植海绵体缺损。三名患者同时接受双通道多普勒超声检查确定的勃起问题继发的阴茎假体植入。评估术后长期并发症和勃起功能，平均随访30个月（范围25-35个月）。所有患者均报告称，​​经过头14个月的平均随访后，阴茎弯曲度得以缓解，可以恢复正常的性功能。放置尸体心包膜后30个月，这三名假肢患者仍报告出良好的性功能。对于八名未进行假体植入的患者，三名斑块大小为中小（<2 x 5厘米）的患者继续表现良好。其余5名斑块大小较大（> 2 x 5 cm）的患者最初情况良好，但后来报道由于静脉渗​​漏而难以维持勃起，因此他们目前正在使用真空压缩装置或Actis环。这五位静脉渗漏患者中有三位有腹膜。两个有背斑，其中一个明显大小（4 x 5厘米）。我们得出的结论是，对于那些未进行假体放置的患者，当斑块大小在中到小（<2 x 5 cm）并且位于背侧时，观察到更好的长期结果。腹侧斑块，极度弯曲或斑块大小> 4 x 5 cm的患者更容易出现静脉闭塞功能障碍，需要进一步干预。较大尺寸（4 x 5厘米）之一。我们得出的结论是，对于那些未进行假体放置的患者，当斑块大小在中到小（<2 x 5 cm）并且位于背侧时，观察到更好的长期结果。腹侧斑块，极度弯曲或斑块大小> 4 x 5 cm的患者更容易出现静脉闭塞功能障碍，需要进一步干预。较大尺寸（4 x 5厘米）之一。我们得出的结论是，对于那些未进行假体放置的患者，当斑块大小在中到小（<2 x 5 cm）并且位于背侧时，观察到更好的长期结果。腹侧斑块，极度弯曲或斑块大小> 4 x 5 cm的患者更容易出现静脉闭塞功能障碍，需要进一步干预。