Shaeer Osama, Shaeer Kamal
Department of Andrology, Faculty of Medicine, Cairo University, Egypt.
J Sex Med. 2006 Jan;3(1):164-9. doi: 10.1111/j.1743-6109.2005.00104.x.
Current girth augmentation techniques rely either on liposuction/injection or on the use of dermal fat grafts. These procedures have serious disadvantages, including regression in gained size, deformities, irregular contour, and asymmetry. Ideally, the augmentation technique should ensure durability and symmetry. This case report describes the first application of a flap (superficial circumflex iliac artery island flap) in penile girth augmentation.
The superficial circumflex iliac vessels were identified and the groin flap was elevated from lateral to medial, rotated toward the penis, and tunneled into a penopubic incision. It was wrapped around the penis short of the corpus spongiosum and insinuated under the glans.
Six months after surgery, the patient had an erect girth of 19.5 cm and a flaccid girth of 16.5 cm, compared with 11 cm and 7 cm, respectively, before surgery, thus maintaining the intraoperative girth gain. The outer surface felt smooth with no lobulation. The size of the glans was proportionate to the shaft's girth.
This case report shows that the application of flaps in penile girth augmentation may provide a reliable alternative to the currently applied techniques. Glans flaring promotes the aesthetic results and is applicable with other techniques of penile girth augmentation.
目前阴茎增粗技术要么依赖抽脂/注射，要么使用真皮脂肪移植。这些手术存在严重缺点，包括增大尺寸的回缩、畸形、轮廓不规则和不对称。理想情况下，增粗技术应确保持久性和对称性。本病例报告描述了皮瓣（旋髂浅动脉岛状皮瓣）在阴茎增粗中的首次应用。
识别出旋髂浅血管，从外侧向内侧掀起腹股沟皮瓣，向阴茎旋转，通过隧道引入耻骨联合阴茎切口。将其环绕阴茎，但不包括海绵体，并插入龟头下方。
术后6个月，患者勃起时阴茎周长为19.5厘米，疲软时为16.5厘米，术前分别为11厘米和7厘米，从而维持了术中增加的周长。外表面感觉光滑，无分叶。龟头大小与阴茎体周长相称。
本病例报告表明，皮瓣在阴茎增粗中的应用可能为当前应用的技术提供一种可靠的替代方法。龟头扩张可改善美学效果，且可与其他阴茎增粗技术联合应用。
