Objective: To compare the long-term results and complications of minimally invasive H-incision complete burying-knot technique and modified Nesbit procedure in penile curvature surgery. Material and Methods: The data of 53 patients who underwent penile curvature surgery in our clinic for Peyronie's disease were retrospectively analyzed. While 27 (50.9%) of the patients had excisional modified Nesbit procedure (Group 1), 26 (49.1%) were applied minimally invasive H-incision complete burying-knot technique (Group 2). The postoperative results and complications of the groups were compared. Results: The mean age of groups was similar (p=0.369). There was no significant difference between the groups in terms of mean operating times (Group 1=41.92±6.93 minute vs Group 2=43.14±6.81 minute, p=0.520). The mean postoperative penile shorthening was 1.07±1.77 cm in Group 1, while it was 0.84±1.59 cm in Group 2 (p=0.625). Mean postoperative palpable suture knots, penile pain and penile numbness were found to be significantly lower in Group 2 (p=0.011, p=0.005, p=0.011 respectively). The mean postoperative International Index of Erectile Function scores were similar in both groups (Group 1=20.14±1.58 vs Group 2=19.73±1.84, p=0.249). Conclusion: Minimally invasive H-incision complete burying-knot technique provides similar success rates with lower postoperative complication compared to the modified Nesbit procedure in penile curvature surgery.
Keywords: Penile diseases; urologic surgical procedures; penile curvature; Peyronie disease
Amaç: Bu çalışmanın amacı, penil kurvatür cerrahisinde minimal invaziv H-insizyon komplet sütür-gömme tekniği ile modifiye Nesbit prosedürünün uzun dönem sonuçlarını ve komplikasyonlarını karşılaştırmaktır. Gereç ve Yöntemler: Kliniğimizde Peyronie hastalığı nedeniyle penil kurvatür cerrahisi yaptığımız 53 hastanın verileri retrospektif olarak incelenmiştir. Hastaların 27'sinde (%50,9) modifiye Nesbit prosedürü uygulanmışken (Grup 1), 26'sına (%49,1) minimal invaziv H-insizyon komplet sütür-gömme tekniği uygulanmıştır (Grup 2). Grupların postoperatif sonuçları ve komplikasyonları karşılaştırılmıştır. Bulgular: Grupların ortalama yaşı benzer bulunmuştur (p=0,369). Ortalama operasyon süreleri bakımından gruplar arasında anlamlı fark görülmemiştir (Grup 1=41,92±6,93 dk ve Grup 2=43, 14±6,81 dk, p=0,520). Postoperatif ortalama penil kısalma Grup 1'de 1,07±1,77 cm iken Grup 2'de 0,84±1,59 cm bulunmuştur (p=0,625). Postoperatif ortalama palpe edilebilir sütür knot varlığı, penil ağrı ve penil hissizliğin Grup 2'de anlamlı olarak düşük olduğu görülmüştür (p=0,011, p=0,005, p=0,011, sırasıyla). Grupların postoperatif Uluslararası Erektil Fonksiyon İndeks skorlarının ise benzer olduğu görülmüştür (Grup 1=20,14±1,58 ve Grup 2=19,73±1,84, p=0,249). Sonuç: Penil kurvatür cerrahisinde minimal invaziv H-insizyon komplet sütür-gömme tekniği modifiye Nesbit prosedürüyle karşılaştırıldığında benzer başarı ve daha düşük komplikasyon oranları sağlamaktadır.
Anahtar Kelimeler: Penis hastalıkları; ürolojik cerrahi işlemler; penil kurvatür; Peyronie hastalığı
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