阴茎延长术联合脂肪颗粒注射治疗阴茎短小的临床效果

Clinical effect of penile lengthening and augmentation with autologous granular fat graft on short penis

目的探讨阴茎延长同期行脂肪筋膜瓣填充及脂肪颗粒注射增粗术治疗阴茎短小患者的临床效果，分析手术并发症的原因及处理对策。方法采用离断浅悬韧带及1／3～2／3深悬韧带以延长阴茎，局部脂肪筋膜瓣填塞断裂韧带腔隙，同时使用离心浓缩脂肪颗粒注射在阴茎Buck筋膜下增粗阴茎。对术前术后阴茎常态下长度、牵拉下长度、直径和周径，以及并发症进行评价。结果34例治疗前后，阴茎常态下长度相差（2．8±0．1）cm、牵拉下长度相差（2．1±0．2）cm、直径相差（0．9±0．1）cm，周径相差（2．8±0．1）cm，性生活满意。主要并发症为伤口愈合不良、包皮水肿及阴茎硬结：其中4例切口11期愈合，8例包皮水肿及硬结达3个月以上消退。结论阴茎延长同期行脂肪筋膜瓣填充及脂肪颗粒注射增粗术治疗阴茎短小，方法操作简单，效果确切；并可以通过细节处理来减少并发症的发生。

Objective To evaluate the effectiveness and safety of autologous granular fat graft applied for penile lengthening and augmentation. Methods After all the superficial ligment and 1/3-2/ 3 part of the deep suspensory-ligament had been cut off for penile lengthening, local pedicaled fasciaadipose flap was designed to fill the depression, the pre-centrifuged autologous granular fat was injected into the space beneath Buck＇s fascia for penile augmentation. Normal length, pulling penis length, diameter, circumference and complications were evaluated. Results 34 cases were performed and followed up for 3-18 months, both ideal length and diameter increase of penis were achieved. The differences of nomal length, pulling-length, the diameter and circumference were （2.8 ± 0.1） cm, （2.1 ± 0.2） cm, （0.9 ± 0.1 ） cm, （2.8± 0.1） cm, respectively. The common complications included poor wound healing in 4 cases, preputial edema and subcutaneous scleroma in 8 cases for 3 months. Conclusions Autologous granular fat graft for penile augmentation during the lengthening surgery is a reliable and effective method and easy procedure. Detail processing can decrease the complications.