Wallen Jared J, Baumgarten Adam S, Kim Tim, Hakky Tariq S, Carrion Rafael E, Spiess Philippe E
Department of Urology, University of Southern Florida, USA.
Department of Genitourinary Oncology, Moffitt Cancer Center, USA.
Int Braz J Urol. 2014 Sep-Oct;40(5):708-9. doi: 10.1590/S1677-5538.IBJU.2014.05.18.
The ventral phalloplasty (VP) has been well described in modern day penile prosthesis surgery. The main objectives of this maneuver are to increase perceived length and patient satisfaction and to counteract the natural 1-2 cm average loss in length when performing implantation of an inflatable penile prosthesis. Similarly, this video represents a new adaptation for partial penectomy patients. One can only hope that the addition of the VP for partial penectomy patients with good erectile function will increase their quality of life. The patient in this video is a 56-year-old male who presented with a 4.0x3.5x1.0 cm, pathologic stage T2 squamous cell carcinoma of the glans penis. After partial penectomy with VP and inguinal lymph node dissection, pathological specimen revealed negative margins, 3/5 right superficial nodes and 1/5 left superficial nodes positive for malignancy. The patient has been recommended post-operative systemic chemotherapy (with external beam radiotherapy) based on the multiple node positivity and presence of extranodal extension. The patient's pre-operative penile length was 9.5 cm, and after partial penectomy with VP, penile length is 7 cm.
现代阴茎假体手术中对腹侧阴茎成形术(VP)已有详细描述。该操作的主要目的是增加阴茎的外观长度和患者满意度,并抵消在植入可膨胀阴茎假体时自然出现的平均1 - 2厘米的长度损失。同样,本视频展示了针对部分阴茎切除患者的一种新改良方法。人们只能希望,对于勃起功能良好的部分阴茎切除患者增加VP手术,能提高他们的生活质量。本视频中的患者是一名56岁男性,患有4.0×3.5×1.0厘米的龟头阴茎鳞状细胞癌,病理分期为T2期。在进行部分阴茎切除联合VP手术及腹股沟淋巴结清扫术后,病理标本显示切缘阴性,右侧5个浅表淋巴结中有3个、左侧5个浅表淋巴结中有1个存在恶性转移。鉴于多个淋巴结转移阳性及存在结外扩展,建议该患者术后进行全身化疗(联合外照射放疗)。患者术前阴茎长度为9.5厘米,在进行部分阴茎切除联合VP手术后,阴茎长度为7厘米。