Chevallier D, Haertig A, Faix A, Droupy S
Service d'urologie-andrologie, hôpital Archet-II, 06202 Nice, France.
Prog Urol. 2013 Jul;23(9):685-95. doi: 10.1016/j.purol.2013.02.011. Epub 2013 Jun 13.
To describe the indications and results of techniques to change the appearance of the penis for aesthetic reasons. Provide recommendations concerning cosmetic surgery of the male genitalia.
We have selected from Medline Database, articles published between 1990 and 2011. Forty articles have been selected excluding papers reporting populations less than five cases per type of procedure.
There is no consensus on the size below which it is justifiable to accept or attempt to modify the size of the penis. Length of the penis in maximal tension less than 9.5 cm or 10 cm in erection can be considered as an acceptable limit, in a patient who suffers from it. The assessment of men asking for penile enlargement must include a psychosexological or psychiatric evaluation, looking for a dysmorphophobia or another psychiatric condition. Penile extenders under medical control must be the first-line treatment option for patient seeking penile lenghtening procedure when justified. In case of failure, three techniques can be used alone or in combination: penile lengthening by section of the suspensory ligaments and suprapubic skin advancement, lipectomy of Mons pubis and scrotal webbing section. The results are modest, the rate of complications significant and satisfaction low. Girth enlargement techniques by injection of autologous fat give inconsistent aesthetic results and satisfaction rates are low. All other techniques remain experimental.
Cosmetic surgery of the penis is associated with a high risk of forensic exposure and surgery should be only proposed after a multidisciplinary consensus, followed by a time of reflection given to the patient after full disclosure. Applications for the purpose of reconstruction surgery after trauma or consequences of cancer treatment are justified.
描述出于美学原因改变阴茎外观的技术的适应症和结果。提供有关男性生殖器整形手术的建议。
我们从Medline数据库中选取了1990年至2011年间发表的文章。排除了报告每种手术类型病例数少于5例的论文后，共选取了40篇文章。
对于阴茎大小低于何种程度才适合接受或尝试改变阴茎大小，目前尚无共识。对于患有阴茎短小症的患者，阴茎在最大张力下长度小于9.5厘米或勃起时小于10厘米可被视为可接受的限度。对要求阴茎增大的男性进行评估时，必须包括心理性学或精神病学评估，以查找畸形恐惧症或其他精神疾病。在有正当理由的情况下，在医学监控下使用阴茎延长器必须是寻求阴茎延长手术患者的一线治疗选择。若失败，可单独或联合使用三种技术：通过切断悬韧带和耻骨上皮肤推进进行阴茎延长、耻骨联合脂肪切除术和阴囊蹼切开术。结果一般，并发症发生率高，满意度低。通过注射自体脂肪增大阴茎周长的技术美学效果不一致，满意度低。所有其他技术仍处于实验阶段。
阴茎整形手术存在较高的法医暴露风险，手术应仅在多学科达成共识后提出，且在向患者充分披露信息后给予其思考时间。因创伤后重建手术或癌症治疗后果而进行的手术是合理的。
