(239) IS BUCCAL MUCOSA THE FUTURE OF PLAQUE INCISION/EXCISION AND GRAFTING FOR PEYRONIE’S DISEASE? A SINGLE-ARM META-ANALYSIS OF AN EMERGING GRAFT
Notice bibliographique
Résumé
Abstract Introduction Peyronie’s disease (PD) is a benign andrological condition that affects mens sexual health. Penile pain, plaques, and shaft curvatures leading to length loss and difficulties in sexual intromission are its hallmark clinical features. Although multiple surgical techniques have been explored in the management of PD, plaque incision/excision and grafting (PIG/PEG) has been described as a feasible option for more severe curvatures. Many graft materials have been explored for PIG/PEG. However, buccal mucosal grafts (BMG) have emerged as a popular, successful, and reliable choice. Objective This systematic review and meta-analysis evaluates PIG/PEG with BMG as a surgical treatment for Peyronie's disease. The outcomes of interest explored were: 1) Penile curvature 2) Erectile function (IIEF-5), and 3) Stretched penile length (SPL). 4) Post-operative functional penile straightening (<20 degrees), and 5) De novo erectile dysfunction. Methods Multiple major databases were thoroughly searched, and all relevant literature, excluding systematic reviews, meta-analyses, case reports, and abstracts, were screened. The outcomes of interest described above were extracted from the eligible studies. Data collection and analysis were done in Microsoft Excel and R Studio, respectively. A proportions and mean differences meta-analysis was supplemented with heterogeneity and publication bias tests. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the eligible studies. A p-value of <0.05 was considered statistically significant. Results Ten publications were eligible for a systematic review, which encompassed data from 226 patients. The studies were mainly observational in design and published between 2005 and 2021 in three different languages (English, Chinese, and Russian). All studies demonstrated promising outcomes for PIG/PEG with BMG. A meta-analysis of mean differences demonstrated a peri-operative curvature reduction of -49.6 degrees (95% CI: -64.4 to -34.9, p < 0.01), IIEF-5 score improvement of 4.45 points (95% CI: -0.07 to 8.9, p =), and SPL preservation with an estimated mean difference of 1.41 cm (95% CI: 0.38 to 2.44, p < 0.01). Further proportional meta-analysis of functional penile straightening and de novo post-operative erectile dysfunction demonstrated pooled estimates of 92% and 7.5%, respectively. Heterogeneity was noted to be significant among the studies. Conclusions Buccal mucosa is a viable, effective, and safe graft option for PIG/PEG in managing PD. Overall, the available literature demonstrates promising results. Despite these positive outcomes, and given the fact that all available literature includes observational studies, there is a unanimous concurrence amongst the urological guideline panels and expert bodies such as the European Association of Urology (EAU), American Urological Association (AUA), Canadian Urological Association (CUA), and European Society for Sexual Medicine (ESSM) that randomized controlled trials are essential to further support these findings and define its benefits, risks and more importantly long-term outcomes. Disclosure No.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».