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001-es BibID:BIBFORM109089
Első szerző:Murányi Mihály (urológus)
Cím:Functional outcomes of glansectomy and reconstruction with split-thickness skin graft / Murányi M., Domoszlai A., Drabik Gy., Flaskó T.
Dátum:2022
ISSN:2666-1683
Megjegyzések:Introduction & Objectives: Surgical treatment of primary penile tumour aims to preserve the function of the penis in addition to oncological efficacy. Glansectomy and reconstruction with split-thickness skin graft (STSG) is a popular method to spare the penis. Our aim was to assess surgical outcomes and preservation of penile function following glans reconstruction with STSG. Materials & Methods: Between 2017 and 2021, 6 glans reconstructions with STSG were performed after partial (2) or total glansectomy (4) due to penile cancer (5) or premalignant lesion (1) at our department. Length of surgery, length of hospital stay, complications, surgical margins and tumour recurrence were studied retrospectively. Penile function was evaluated by the International Index of Erectile Function (IIEF-5) questionnaire; a question about satisfaction with appearance of the penis (1: very unsatisfied, 2: unsatisfied, 3: uncertain, 4: satisfied, 5: very satisfied) and a question regarding ability to urinate while standing (yes/no). Data from the 6 patients (group A) who underwent glans reconstruction were compared with data from 11 patients (group B) who underwent partial or total glansectomy without reconstruction between 2011 and 2021 and 15 patients (group C) who underwent penile amputation between 2011 and 2021 at our department. During the questionnaire survey, data from patients in groups A and B who subsequently underwent amputation due to surgical margin positivity or recurrence were classified in group C. Results: The mean age of the patients was 59.7 ? 20.3, 63.8 ? 11.8 and 62.6 ? 11.5 years; mean operating times were 139.5 ? 13.8, 69.1 ? 27.8 and 102.2 ? 43.1 minutes; mean length of hospital stay were 7.7 ? 1.6, 2.9 ? 1.8 and 6.3 ? 5.6 days in groups A, B and C, respectively. 0, 1 (total urinary retention) and 2 (wound-edge bleeding and wound infection) complications occurred in the postoperative period; surgical margin positivity was observed in 1, 5 and 0 cases, tumour recurrence was found in 0, 2 and 3 cases in groups A, B and C, respectively. 100%, 67% and 47% of patients responded to the questionnaire on an average of 2.8 ? 1.4, 7.2 ? 3.0 and 5.2 ? 3.2 years after surgery in groups A, B and C, respectively. The mean IIEF-5 questionnaire scores were 21.4 ? 3.6, 7.5 ? 8.3 and 4.4 ? 5.8; for the question on the satisfaction with appearance of the penis, the mean scores were 4.2 ? 0.8, 2.8 ? 1.2 and 2.6 ? 1.4 in groups A, B and C, respectively. 100%, 100% and 56% of patients in groups A, B and C can urinate while standing. Conclusions: Glansectomy and reconstruction with STSG is a more complex surgical intervention compared to glansectomy and penile amputation without reconstruction. Thanks to this, the duration of the operation and the period of hospital stay are also longer. However, after glans reconstruction, patients are not only more satisfied with the appearance of the penis, but their sexual function is also better.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:European Urology Open Science. - 44 : Suppl. 3 (2022), p. S242. -
További szerzők:Domoszlai A. Drabik Gyula (1978-) (urológus, andrológus) Flaskó Tibor (1960-) (urológus)
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