应用脱细胞异体真皮移植增粗阴茎的临床研究

Clinical study of penile augmentation using acellular dermal matrix

目的:研究应用脱细胞异体真皮移植增粗阴茎的效果、手术并发症及移植物应植入的最佳解剖层次。方法:应用脱细胞异体真皮植入增粗阴茎25例,A组13例,移植物植入Buck’s筋膜深面,白膜浅面;B组12例,移植物植入Dartos筋膜深面,Buck’s筋膜浅面。结果:术后阴茎中段周径增大1.1～3.2cm,A、B两组均无阴茎畸形、勃起功能障碍、脱细胞真皮外露等并发症发生,A组4例早期出现龟头麻木,3个月后恢复正常,B组无类似病例。结论:应用脱细胞异体真皮移植增粗阴茎效果明显,手术创伤小,无供区损伤,但植入Buck’s筋膜深面可引起术后早期龟头麻木。

Objective To investigate the enhancement effect and postoperative complication of penile augmentation using acellular dermal matrix and to find out the appropriate anatomical space in which the implants should be placed. Methods From Jan. 2006 to Sep. 2008, 25 patients were divided into group A and group B randomly and underwent augmentation phalloplasty. In group A, acellular dermal matrix was implanted between Buck＇s fascia superiorly and tunica albuginea inferiorly, but in group B, implanted between Dartos fascia superiorly and Buck＇s fascia inferiorly. Results The penile midshaft circumference increased 1.1 N3.2cm postoperatively. No serious complication such as penile deformity, erectile dysfunction and implant exposure occured in both group A and group B. However, glans numbness was complained in 4 cases in group A immediately after operation but disappeared 3 months later. There was no such complaint in group B. Conclusions The augmentation phalloplasty with application of acellular dermal matrix was easily performed with good enhancement effect and minimal morbidity and without donor site injuries, however, implants placed under Buck＇s fascia may cause glans numbness in some cases.