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Advisor(s)
Abstract(s)
A doença de Peyronie caracteriza-se pela presença de uma placa de tecido fibroso na
túnica albugínea dos corpos cavernosos e, consequentemente, uma curvatura no pénis
em ereção. O tratamento cirúrgico é o tratamento de eleição nos casos em que a curvatura
impossibilita a penetração ou implique relações sexuais insatisfatórias. Existem
diferentes abordagens cirúrgicas dependendo da complexidade da curvatura peniana.
Nos casos de doença severa, ou com resposta erétil inadequada opta-se por
implementação de prótese peniana. Os pacientes com função erétil mantida têm
indicação para a cirurgia de reconstrução, a escolha da técnica está dependente do grau
e tipo de deformidade. Em curvaturas mais simples opta-se por técnicas de
encurtamento da túnica albugínea, como a cirurgia de plicatura. Em deformidades
proeminentes ou com curvaturas superiores a 60º está aconselhada técnicas com
alongamento da túnica albugínea, especificamente incisão ou excisão parcial e enxerto.
Com o avançar dos tempos e desenvolvimento da Medicina, novos enxertos são utilizados
nesta cirurgia, pelo que existem diversas opções.
Esta dissertação tem como objetivo aferir os vários enxertos, comparando vantagens e
desvantagens de cada um deles.
Peyronie's disease is characterized by the presence of a fibrous tissue plaque in the tunica albuginea of the corpus cavernosum, and consequently a curvature in the erect penis. Surgical treatment is the treatment of choice in cases where curvature makes penetration impossible or implies unsatisfactory sexual intercourse. There are different surgical approaches depending on the complexity of the penile curvature. In the man with Peyronie Disease who also has Erectile Disfunction that does not respond to medical therapy, published surgical algorithms have indicated that penile prosthesis placement is the procedure of choice. Patients with efficient erectile function are indicated for reconstructive surgery, the choice of technique depends on the degree and type of deformity. In simpler curves, it is opted for tunical shortening procedures, such as plication surgery. Incision or partial excision and grafting is recommended for those men with more complex curves of greater 60º and/or have a destabilizing hourglass. With the advancement of times and the development of Medicine, new grafts are used in this surgery, so there are several options. This dissertation aims to assess the various grafts, comparing the advantages and disadvantages of each one.
Peyronie's disease is characterized by the presence of a fibrous tissue plaque in the tunica albuginea of the corpus cavernosum, and consequently a curvature in the erect penis. Surgical treatment is the treatment of choice in cases where curvature makes penetration impossible or implies unsatisfactory sexual intercourse. There are different surgical approaches depending on the complexity of the penile curvature. In the man with Peyronie Disease who also has Erectile Disfunction that does not respond to medical therapy, published surgical algorithms have indicated that penile prosthesis placement is the procedure of choice. Patients with efficient erectile function are indicated for reconstructive surgery, the choice of technique depends on the degree and type of deformity. In simpler curves, it is opted for tunical shortening procedures, such as plication surgery. Incision or partial excision and grafting is recommended for those men with more complex curves of greater 60º and/or have a destabilizing hourglass. With the advancement of times and the development of Medicine, new grafts are used in this surgery, so there are several options. This dissertation aims to assess the various grafts, comparing the advantages and disadvantages of each one.
Description
Keywords
Doença de Peyronie Enxerto Tachosil Tratamento Cirúrgico