Penis Kırıklarının Acil Cerrahi Tedavisinin Sonuçları: Dikiş Malzemeleri, Gecikmiş Onarım ve Ameliyat Sonrası Sonuçlar Üzerine Bir Çalışma
Yıl 2024,
Cilt: 19 Sayı: 3, 145 - 150, 30.10.2024
Süleyman Sağır
,
Ferhat Çelikkaleli
,
Müslüm Ergün
,
Cüneyt Özden
,
Mustafa Güler
,
İzzettin Toktaş
Öz
Amaç: Bu çalışma, penis kırığı (PK) hastalarında cerrahi zamanlama ve dikiş malzemelerinin ameliyat sonrası sonuçlar üzerindeki etkisini, özellikle penil kurvatür (PK) gelişimine odaklanarak incelemektedir.
Gereç ve Yöntemler: 2015-2024 yılları arasında penis kırıkları nedeniyle tedavi edilen 63 hasta üzerinde retrospektif bir analiz yapıldı. Ameliyat süresi, dikiş malzemeleri ve PK gibi ameliyat sonrası komplikasyonlar hakkındaki veriler toplandı.
Bulgular: Hastaların %27’sinde PK gelişti ve bu hastalarda cerrahi müdahale süresi, PK gelişmeyenlere kıyasla anlamlı derecede daha uzun bulundu. Dikiş malzemesi türü (2-0 Prolene ve 3-0 Vicryl) PK veya nodül oluşumu üzerinde anlamlı bir etkiye sahip değildi.
Sonuç: Gecikmiş cerrahi müdahale, PK riskinin artmasıyla ilişkilidir. Komplikasyonları azaltmak için erken cerrahi önerilmektedir, ancak dikiş malzemesi sonuçları etkilememektedir.
Kaynakça
- 1. Kominsky H, Beebe S, Shah N, et al. Surgical reconstruction for penile fracture: a systematic review. Sexual Med J. 2019;2:1-9. https://doi.org/10.1089/end.2008.0596
- 2. Muentener M. Long term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576-589. https://doi.org/10.1097/01.ju.0000123641.48653.5d
- 3. Shafi H, Ramaji A, Kasaeeian A, et al. Report of 84 cases of penile fracture in Beheshti Hospital center. J Mazandaran Univ Med Sci. 2005;15:37-43.
- 4. Ateyah A, Mostafa T, Nasser TA, et al. Penile fracture: surgical repair and late effects on erectile function. J Sex Med. 2008;5:1496-1502. https://doi.org/10.1111/j.1743-6109.2008.00740.x
- 5. Jack GS, Garraway I, Reznichek R, Rajfer J. Current treatment options for penile fractures. Rev Urol. 2004;6(3):114-120.
- 6. Mydlo J. Surgeon experience with penile fracture. J Urol. 2001;166:526. https://doi.org/10.1016/S0022- 5347(05)65831-3
- 7. Zargooshi J. Penile fracture in Kermanshah, Iran: the longterm results of surgical treatment. BJU Int. 2002;89:890- 897. https://doi.org/10.1046/j.1464-410x.2002.02795.x
- 8. Bolat M. Effects of penile fracture and its surgical treatment on psychosocial and sexual function. Int J Impotence Res. 2017;29:244-249. https://doi.org/10.1038/ijir.2017.11
- 9. Reise L. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Advances in Urol. 2014;1-9. https://doi. org/10.1155/2014/878132
- 10. Ahmad A, Majzoub A, Canguven O, Raidh TA. Alteration in the etiology of penile fracture in the Middle East and Central Asia regions in the last decade; a literature review. Urol Ann. 2015;7:284-288. https://doi.org/10.4103/0974- 7796.152933
- 11. Regan T. Comparison of Poliglecaprone-25 and Polyglactin-910 in cutaneous surgery. Dermatol Surg. 2013;39:1340-1344. https://doi.org/10.1111/dsu.12248
- 12. Niessen FB, Spauwen PH, Kon M. The role of suture material in hypertrophic scar formation: Monocryl vs Vicryl-rapid. Ann Plast Surg. 2000;39:254-260. https:// doi.org/10.1097/00000637-200009000-00009
- 13. Altan M, Hazir B, Baltaci KE, et al. Long term complications of penile fracture repair: Erectile dysfunction and penile curvature. Rev Int Androl. 2022;20(2):116-120. https:// doi.org/10.1016/j.androl.2022.01.001
- 14. Yilmaz H, Avci IE, Cinar NB, et al. Urethral rupture concomitant with penile fracture does not adversely affect functional outcomes. Urologia. 2023;90(3):553- 558. https://doi.org/10.1177/03915603221108505
- 15. Chahal R, Gogoi NK, Sundaram SK, Weston PM. Corporal plication for penile curvature caused by Peyronie‘s disease: the patients‘ perspective. BJU Int. 2001;87:352- 356. https://doi.org/10.1046/j.1464-410x.2001.00142.x
- 16. Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology. 1999;54:352-355. https://doi.org/10.1016/ S0090-4295(99)00231-5
- 17. Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576-579. https://doi. org/10.1097/01.ju.0000123641.48653.5d
- 18. Yapanoglu T, Aksoy Y, Adanur S, et al. Seventeen years‘ experience of penile fracture: conservative vs. surgical treatment. J Sex Med. 2009;6:2058-2063. https://doi. org/10.1111/j.1743-6109.2009.01309.x
- 19. Gamal WM, Osman MM, Hammady A, et al. Penile fracture: long-term results of surgical and conservative management. J Trauma. 2011;71:491-493. https://doi. org/10.1097/TA.0b013e3182225e4d
- 20. Wong NC, Dason S, Bansal RK, et al. Can it wait? A systematic review of immediate vs. delayed surgical repair of penile fractures. Can Urol Assoc J. 2017;11:53- 60. https://doi.org/10.5489/cuaj.4017
- 21. Amer T, Wilson R, Chlosta P, et al. Penile fracture: a meta-analysis. Urol Int. 2016;96:315-329. https://doi. org/10.1159/000444710
- 22. Dell’Atti L, Scarcella S, Tallè M, et al. Simultaneous curvature correction at the time of the penile fracture repair: surgical and functional outcomes. Res Rep Urol. 2019;11:105-110. https://doi.org/10.2147/RRU.S198365
Outcomes of Emergency Surgical Treatment for Penile Fractures: A Study on Suture Materials, Delayed Repair, and Postoperative Results
Yıl 2024,
Cilt: 19 Sayı: 3, 145 - 150, 30.10.2024
Süleyman Sağır
,
Ferhat Çelikkaleli
,
Müslüm Ergün
,
Cüneyt Özden
,
Mustafa Güler
,
İzzettin Toktaş
Öz
Objective: This study examines the impact of surgical timing and suture materials on postoperative outcomes in penile fracture patients, particularly focusing on the development of penile curvature (PC).
Materials and Methods: A retrospective analysis was conducted on 63 patients treated for penile fractures between 2015 and 2024. Data on the time to surgery, suture materials, and postoperative complications such as PC were collected.
Results: PC occurred in 27% of patients, with a significantly longer surgical delay in those with PC compared to those without. Suture material type (2-0 Prolene vs. 3-0 Vicryl) had no significant effect on PC or nodule formation.
Conclusion: Delayed surgical intervention is associated with an increased risk of PC. Early surgery is recommended to reduce complications, while suture material does not influence outcomes.
Etik Beyan
Ethical approval was obtained from the Gazi Yaşargil Training and Research Hospital, Health Sciences University, on June 7, 2024, with reference number 88.
Kaynakça
- 1. Kominsky H, Beebe S, Shah N, et al. Surgical reconstruction for penile fracture: a systematic review. Sexual Med J. 2019;2:1-9. https://doi.org/10.1089/end.2008.0596
- 2. Muentener M. Long term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576-589. https://doi.org/10.1097/01.ju.0000123641.48653.5d
- 3. Shafi H, Ramaji A, Kasaeeian A, et al. Report of 84 cases of penile fracture in Beheshti Hospital center. J Mazandaran Univ Med Sci. 2005;15:37-43.
- 4. Ateyah A, Mostafa T, Nasser TA, et al. Penile fracture: surgical repair and late effects on erectile function. J Sex Med. 2008;5:1496-1502. https://doi.org/10.1111/j.1743-6109.2008.00740.x
- 5. Jack GS, Garraway I, Reznichek R, Rajfer J. Current treatment options for penile fractures. Rev Urol. 2004;6(3):114-120.
- 6. Mydlo J. Surgeon experience with penile fracture. J Urol. 2001;166:526. https://doi.org/10.1016/S0022- 5347(05)65831-3
- 7. Zargooshi J. Penile fracture in Kermanshah, Iran: the longterm results of surgical treatment. BJU Int. 2002;89:890- 897. https://doi.org/10.1046/j.1464-410x.2002.02795.x
- 8. Bolat M. Effects of penile fracture and its surgical treatment on psychosocial and sexual function. Int J Impotence Res. 2017;29:244-249. https://doi.org/10.1038/ijir.2017.11
- 9. Reise L. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Advances in Urol. 2014;1-9. https://doi. org/10.1155/2014/878132
- 10. Ahmad A, Majzoub A, Canguven O, Raidh TA. Alteration in the etiology of penile fracture in the Middle East and Central Asia regions in the last decade; a literature review. Urol Ann. 2015;7:284-288. https://doi.org/10.4103/0974- 7796.152933
- 11. Regan T. Comparison of Poliglecaprone-25 and Polyglactin-910 in cutaneous surgery. Dermatol Surg. 2013;39:1340-1344. https://doi.org/10.1111/dsu.12248
- 12. Niessen FB, Spauwen PH, Kon M. The role of suture material in hypertrophic scar formation: Monocryl vs Vicryl-rapid. Ann Plast Surg. 2000;39:254-260. https:// doi.org/10.1097/00000637-200009000-00009
- 13. Altan M, Hazir B, Baltaci KE, et al. Long term complications of penile fracture repair: Erectile dysfunction and penile curvature. Rev Int Androl. 2022;20(2):116-120. https:// doi.org/10.1016/j.androl.2022.01.001
- 14. Yilmaz H, Avci IE, Cinar NB, et al. Urethral rupture concomitant with penile fracture does not adversely affect functional outcomes. Urologia. 2023;90(3):553- 558. https://doi.org/10.1177/03915603221108505
- 15. Chahal R, Gogoi NK, Sundaram SK, Weston PM. Corporal plication for penile curvature caused by Peyronie‘s disease: the patients‘ perspective. BJU Int. 2001;87:352- 356. https://doi.org/10.1046/j.1464-410x.2001.00142.x
- 16. Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology. 1999;54:352-355. https://doi.org/10.1016/ S0090-4295(99)00231-5
- 17. Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576-579. https://doi. org/10.1097/01.ju.0000123641.48653.5d
- 18. Yapanoglu T, Aksoy Y, Adanur S, et al. Seventeen years‘ experience of penile fracture: conservative vs. surgical treatment. J Sex Med. 2009;6:2058-2063. https://doi. org/10.1111/j.1743-6109.2009.01309.x
- 19. Gamal WM, Osman MM, Hammady A, et al. Penile fracture: long-term results of surgical and conservative management. J Trauma. 2011;71:491-493. https://doi. org/10.1097/TA.0b013e3182225e4d
- 20. Wong NC, Dason S, Bansal RK, et al. Can it wait? A systematic review of immediate vs. delayed surgical repair of penile fractures. Can Urol Assoc J. 2017;11:53- 60. https://doi.org/10.5489/cuaj.4017
- 21. Amer T, Wilson R, Chlosta P, et al. Penile fracture: a meta-analysis. Urol Int. 2016;96:315-329. https://doi. org/10.1159/000444710
- 22. Dell’Atti L, Scarcella S, Tallè M, et al. Simultaneous curvature correction at the time of the penile fracture repair: surgical and functional outcomes. Res Rep Urol. 2019;11:105-110. https://doi.org/10.2147/RRU.S198365