Tutoplast®同种异体心包移植术在瘢痕组织切除和远端下体缺损修复的可充气阴茎假体的复杂再植

UroPrecision Pub Date : 2023-10-29 DOI:10.1002/uro2.24
Kyle A. Blum, William Jones, Lauren Conroy, Justin Mehr, Travis Green, Run Wang
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引用次数: 0

摘要

背景:充气阴茎假体(IPP)患者在使用多年或留置Foley导管后可能会出现糜烂。IPP糜烂应作为感染处理,切除整个IPP。由于广泛的瘢痕形成,在糜烂患者中更换ipp具有挑战性。为了IPP再植的长期成功,使用合适的移植物材料可能是必要的,以关闭和加强在困难的下体扩张或重大疤痕去除后的下体缺损。我们报告了一名患者,2007年因勃起功能障碍和Peyronie病而放置IPP, 2018年在冠状动脉搭桥手术中放置Foley导管后出现排尿困难和IPP移位的感觉。体格检查发现左髂胫腓骨柱,办公室膀胱镜检查发现在小舟窝附近有缺损。然后进行IPP的完全外植。IPP的再植入术于2021年进行,需要切除下体瘢痕组织,并使用Tutoplast®心包异体移植物修复左侧下体远端缺损。手术成功,IPP位置正确,功能良好,无阴茎畸形。结论在复杂IPP修复的情况下,应考虑移植材料的应用。Tutoplast®同种异体心包移植加固具有长期耐用性、灵活性和较低的感染风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Complex reimplantation of an inflatable penile prosthesis with scar tissue excision and distal corporal defect repair with Tutoplast® pericardium allograft
Abstract Background Patients with inflatable penile prostheses (IPP) may experience erosions after years of use or after indwelling Foley catheter placement. IPP erosions should be managed as an infection with the entire IPP removed. Replacing IPPs in erosion patients can be challenging due to extensive scarring development. Using proper graft materials may be necessary to close and reinforce the corporal defect after difficult corporal dilation or significant scar removal for the long‐term success of IPP reimplantation. Case Presentation Herein we report a patient with a history of IPP placement in 2007 for erectile dysfunction and Peyronie's disease, presenting in 2018 with dysuria and a feeling of IPP displacement following Foley catheter placement for coronary artery bypass graft surgery. The left cylinder of the IPP was observed by physical examination and a defect near the fossa navicularis was discovered during office cystoscopy. A complete explantation of IPP was then performed. Reimplantation of the IPP was performed in 2021 which required excision of corporal scar tissue and repair of a left distal corporal defect using a Tutoplast® pericardium allograft. The procedure was successful with proper IPP position and good function without any penile deformity. Conclusion The use of graft materials in the management of corporeal defects should be considered in the setting of complex IPP revision. The Tutoplast® pericardium allograft reinforcement can provide long‐term durability, flexibility, and a lower risk of infection.
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