Serbian Academy of Science and Arts, School of Medicine-University of Belgrade, Belgrade, Serbia.
J Sex Med. 2010 Sep;7(9):3206-15. doi: 10.1111/j.1743-6109.2009.01545.x.
Autologous tissue engineering with biodegradable scaffolds is a new treatment option for real penile girth enhancement.
The aim of this article is to evaluate tissue remodeling after penile girth enhancement using this technique.
Between June 2005 and May 2007, a group of 12 patients underwent repeated penile widening using biodegradable scaffolds enriched with expanded autologous scrotal dartos cells. Clinical monitoring was parallel to histological investigation of tissue remodeling. During second surgical procedure, biopsies were obtained 10-14 months after first surgery (mean 12 months, N=6) and compared with those obtained after 22-24 months (mean 23 months, N=6), and control biopsies from patients who underwent circumcision (N=5). Blind evaluation of histomorphometrical and immunohistochemical finding was performed in paraffin sections.
Penile girth gain in a flaccid state ranged between 1.5 and 3.8 cm (mean 2.1 ± 0.28 cm) and in full erection between 1.2 and 4 cm (mean 1.9 ± 0.28 cm). Patients' satisfaction, defined by a questionnaire, was good (25%) and very good (75%).
In biopsies obtained 10-14 months after first surgery, highly vascularized loose tissue with collagen deposition associated with small foci of mild chronic and granulomatous inflammation surrounding residual amorphous material was observed. Fibroblast-like hyperplasia and small vessel neoangiogenesis occurred intimately associated with the progressive growth of vascular-like structures from accumulation of CD34 and alpha-smooth muscle actin-positive cells surrounding residual scaffold-like amorphous material. Capillary neoangiogenesis occurred inside residual amorphous material. In biopsies obtained after 22-24 months, inflammation almost disappeared and tissue closely resembled that of the dartos fascia of control group.
Autologous tissue engineering using expanded scrotal dartos cells with biodegradable scaffolds is a new and promising method for penile widening that generates progressive accumulation of stable collagen-rich, highly vascularized tissue matrix that closely resemble deep dartos fascia.
利用可生物降解支架进行自体组织工程是一种治疗真实阴茎周长增大的新方法。
本文旨在评估使用该技术进行阴茎周长增大后的组织重塑。
2005 年 6 月至 2007 年 5 月，一组 12 例患者使用富含膨胀自体阴囊球海绵体肌细胞的可生物降解支架进行了多次阴茎增宽。临床监测与组织重塑的组织学研究平行进行。在第二次手术中，在第一次手术后 10-14 个月（平均 12 个月，N=6）获得活检，并与第二次手术后 22-24 个月（平均 23 个月，N=6）获得的活检进行比较，并与接受环切术的患者的对照活检进行比较（N=5）。在石蜡切片中对组织形态计量学和免疫组织化学发现进行盲法评估。
在松弛状态下，阴茎周长增加 1.5-3.8cm（平均 2.1±0.28cm），在完全勃起时增加 1.2-4cm（平均 1.9±0.28cm）。通过问卷定义的患者满意度为良好（25%）和非常好（75%）。
在第一次手术后 10-14 个月获得的活检中，观察到高度血管化的疏松组织，伴有胶原沉积，伴有小灶轻度慢性和肉芽组织炎症，周围有残余的无定形物质。成纤维细胞样增生和小血管新生发生在血管样结构从围绕残余支架样无定形物质的 CD34 和α-平滑肌肌动蛋白阳性细胞的积累中，与渐进生长密切相关。毛细血管新生发生在残余无定形物质内。在 22-24 个月后获得的活检中，炎症几乎消失，组织与对照组的球海绵体筋膜非常相似。
使用可生物降解支架和膨胀阴囊球海绵体肌细胞的自体组织工程是一种新的、有前途的阴茎增宽方法，可产生稳定的富含胶原、高度血管化的组织基质的渐进积累，与深部球海绵体筋膜非常相似。
