精巣鞘膜を用いて整復術を施行したペイロニー病

Autografting of tunica vaginalis testis for Peyronie's disease

患者は67歳の男性。2003年1月，屈曲による性交不能を主訴に当科を初診した。勃起能，射精能は正常。屈曲は約60度。硬結は背側環状溝付近より陰茎根部まで広範に認められた。約1年間経過観察するも変化なく，手術目的に2004年1月入院した。手術法は陰茎海綿体白膜切除，および右陰囊より採取した精巣鞘膜による補塡術が施行されたが，軽度屈曲が確認されたため，Nesbit法が追加された。

We reported a case of Peyronie's disease in a 68-year-old male patient with progressive induration in the dorsal region of the penis. Because penile curvature was of high degree,we performed autografting by tunica vaginalis testis to cover the defect resulted from surgical excision of indurated tunica albuginea of the corpora cavernosa. We also added modified Nesbit procedure. Two months after operation,he could achieve an erection,although there remained a slight curvature. A tunica vaginalis testis autograft was an ideal substitute for tunica albuginea in this case,but for more wide induration,a venous patch graft from the saphenous vein might be indicated.