HADM"隐痕"阴茎增粗延长术  

Human Acellular Dermal Matrix Applied to Penile Augmentation with Hidden Incision

作　　者：蒋冠军 祝葆华 JIANG Guan-jun;ZHU Bao-hua(Beijing Zhongke Jingfu International Institute of Andrology,Beijing City,100094,China;Shenzhen Runyan Cosmetic SurgeryClinic,Guangdong Province,518000,China;The Second Clinical School of Guangdong Medical University,Guangdong Province,523808,China)

机构地区：[1]北京中科京附国际男科研究院,北京100094 [2]深圳润颜医疗美容门诊部,广东深圳518000 [3]广东医科大学第二临床医学院,广东东莞523808

出　　处：《中国医疗美容》2020年第3期21-25,共5页China Medical Cosmetology

摘　　要：目的探讨HADM(脱细胞异体真皮)"隐痕"阴茎增粗延长术的操作要点和临床效果.方法从本手术项目组2018年1月至2019年12月期间阴茎整形案例中,随机选择50例HADM"隐痕"阴茎增粗延长术作为研究对象.均采用阴茎冠状沟切口,在Buck's筋膜浅面分离脱套至阴茎根部,离断阴茎浅悬韧带、部分深悬韧带;距冠状沟l.5-2.0cm处环形切开Buck's筋膜,将HADM补片前部植于Buck's筋膜与白膜间,后部植于Dartos筋膜与Buck's筋膜间,缝合Dartos筋膜及皮肤切口.测算平均手术时间;观察术前、术后即刻疲软状态下阴茎周径、长度,计算阴茎增粗及延长数值;观察术后并发症及其发生率;术后3月随访求美就医者对手术效果和性生活改善的满意度.结果本组50例阴茎短小综合征实施了HADM"隐痕"阴茎增粗延长术,平均手术时间50min;与术前比较,术后疲软状态阴茎周径平均增加了2.5cm、阴茎长度平均增加3.0cm;术后5例早期出现包皮水肿;未发生阴茎包皮肤坏死、补片外露等并发症;术后3月随访,均对阴茎外形和性生活改善比较满意.结论HADM"隐痕"阴茎增粗延长的关键操作在于选用阴茎冠状沟切口、离断阴茎浅悬韧带和部分深悬韧带、HADM补片前部植于Buck's筋膜与白膜间而后部植于Dartos筋膜与Buck's筋膜间;该术式阴茎增粗、延长效果确切,具有安全性高、植入材料易于获得、手术可操作性强等优势,值得临床推广应用.Objective To investigate the key procedure and clinical effects of HADM(human acellular dermal matrix)for penis augmentation with hidden incisions.Methods From the penile plastic surgery cases of this surgical project group between January 2018 and December 2019,50 cases of penis augmentation with HADM for hidden incisions were randomly selected as the study subjects.All cases were performed with a penile coronal incision.The superficial fascia of Buck's was isolated and removed to the root of the penis,the penile superficial and partial deep ligamenta suspensorium were severed.Circumcision of Buck's fascia from coronal sulcus l.5-2.0 cm,the anterior portion of the HADM patch was planted between the Buck's fascia and the white membrane,and the posterior portion between the Dartos fascia and the Buck's fascia.Then Dartos fascia and skin incisions are stitched.Average operating time was measured.Peripenal diameter and length of penis in weak state were observed before and after operation,then the penile thickening and extension values calculated.The postoperative complications and their incidence were observed and the patients'satisfaction with the effect of surgery and the improvement of their sex life were followed up.Results 50 patients with short penis syndrome were performed by penis augmentation with HADM for hidden incisions,their average operation time was 50 minutes.The average diameter of the postoperative penis in weak state increased by 2.5 cm and the average length of the penis by 3.0 cm.There were 5 cases with prepuce edema,no complications such as skin necrosis and patch exposure after operation.The patients were satisfied with the improvement of penis appearance and sex life in the follow-up three months after operation.Conclusion The key procedures of penis augmentation with hidden incisions by HADM could be penile coronal incision,penile superficial and partial deep ligamenta suspensorium severed,HADM patch planted between the Buck's fascia and the white membrane and the posterior portion between

关 键 词：阴茎 增粗 延长 脱细胞异体真皮(HADM) "隐痕" 

分 类 号：R699.8[医药卫生—泌尿科学]