Garaffa Giulio, Raheem Amr A, Christopher Nim A, Ralph David J
St Peter's Andrology Centre and The Institute Of Urology, London, UK.
BJU Int. 2009 Sep;104(6):852-6. doi: 10.1111/j.1464-410X.2009.08424.x. Epub 2009 Feb 23.
To report our experience of total phallic reconstruction (TPR) with the use of the radial-artery free flap (RAFF) in patients who have had a subtotal penectomy for penile or urethral cancer, as the goal of TPR is the creation of a sensate and cosmetically acceptable phallus with an incorporated neourethra that allows the patient to void while standing, and with the insertion of a penile implant to resume sexual activities, improving quality of life.
The notes of the 15 patients who had undergone RAFF TPR between January 1998 and May 2008 were reviewed retrospectively. The surgical outcome, cosmesis of the phallus, complications, eventual need for revision surgery and patient satisfaction were recorded during the follow-up.
This technique allowed the reconstruction of a cosmetically acceptable phallus in all patients. After a median (range) follow-up of 20 (1-68) months all patients were satisfied with the cosmesis and size of the phallus, and 14 were able to void while standing. Among the seven patients who have subsequently had insertion of a penile prosthesis, five can now engage in sexual intercourse. Urethral strictures and fistulae were the commonest complications in, respectively, three and four cases, and one patient had his penile prosthesis explanted because of infection.
RAFF phalloplasty is an excellent technique for TPR, giving excellent cosmetic and functional results.
报告我们使用桡动脉游离皮瓣（RAFF）进行全阴茎重建（TPR）的经验，这些患者因阴茎癌或尿道癌接受了次全阴茎切除术，因为TPR的目标是创建一个具有感觉功能且外观可接受的阴茎，并包含一条新尿道，使患者能够站立排尿，同时植入阴茎假体以恢复性活动，从而提高生活质量。
回顾性分析1998年1月至2008年5月间接受RAFF TPR的15例患者的病历。随访期间记录手术结果、阴茎外观、并发症、最终是否需要翻修手术以及患者满意度。
该技术使所有患者都能重建出外观可接受的阴茎。中位（范围）随访20（1 - 68）个月后，所有患者对阴茎的外观和大小都很满意，14例患者能够站立排尿。在随后植入阴茎假体的7例患者中，5例现在能够进行性交。尿道狭窄和瘘管分别是最常见的并发症，各有3例和4例，1例患者因感染取出了阴茎假体。
RAFF阴茎成形术是TPR的一种优秀技术，能带来出色的美容和功能效果。
