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阴茎成形术后阴茎植入物的手术结果:95例手术的回顾性分析

Surgical Outcomes of Erectile Implants After Phalloplasty: Retrospective Analysis of 95 Procedures.

作者信息

Neuville Paul, Morel-Journel Nicolas, Maucourt-Boulch Delphine, Ruffion Alain, Paparel Philippe, Terrier Jean-Etienne

机构信息

Department of Urology, Centre hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite Cedex, France.

Department of Biostatistics, Hospices Civils de Lyon, Lyon, France.

出版信息

J Sex Med. 2016 Nov;13(11):1758-1764. doi: 10.1016/j.jsxm.2016.09.013. Epub 2016 Sep 29.


DOI:10.1016/j.jsxm.2016.09.013
PMID:27693264
Abstract

INTRODUCTION: The creation of a neophallus is a complex surgery that must meet functional and esthetic requirements. It is a long and demanding surgical process whose final stage consists of the implantation of a rigid or inflatable material that can be used to reproduce an erection. Data in the literature are scarce, with only the pioneering series present, which includes the use of the first devices and techniques. AIM: To report the outcome of patients with phalloplasty after implantation of erectile implants using standardized surgical techniques and the use of recent prosthesis types with or without a vascular graft. METHODS: This is a retrospective hospital-based analysis of all patients with phalloplasty who underwent implantation of an erectile prosthesis from March 2007 to May 2015. Factors associated with complications were investigated by multivariate logistic regression analysis. MAIN OUTCOME MEASURES: Early-onset (during the first month after surgery) and late-onset complications, including erosion, infections, malpositioning, and dysfunction. RESULTS: Sixty-nine patients were included in the study and 95 procedures were analyzed. After a median follow-up of 4 years (minimum = 169 days, maximum = 6.1 years), the original prosthesis was still in place in 43 patients (62.3%). Patients underwent phalloplasty after female-to-male transsexualism (n = 62, 89.9%), malformation (n = 4, 5.8%), or trauma (n = 3, 4.3%). The proportions for the different types of phalloplasty were 58% for forearm free flap phalloplasty (n = 40), 33.3% for suprapubic phalloplasty (n = 23), and 7% for other (n = 6). The erectile prostheses used were the two-piece AMS Ambicor (n = 71, 74.7%), the Ambicor with a vascular graft (n = 19, 20.0%), and the AMS 700CXR, AMS 700CX, or AMS600-650 (n = 5, 5.2%). There were no early-onset complications in 89 procedures (93.7%) and, when present, they were always related to infection (n = 4, 4.2%). Late-onset complications were erosion (n = 4, 4.2%), infection (n = 4, 4.2%), dysfunction (n = 10, 10.5%), and malpositioning (n = 12, 12.6%). No significant difference was observed for malpositioning (12.7% vs 10.5%, P = .87) and dysfunction (7.0% vs 10.5%, P = .78) between the AMS Ambicor prosthesis and the Ambicor prosthesis with a vascular graft. CONCLUSION: This study provides updated data on complications after the implantation of erectile implants. Multicenter studies, including the evaluation of patient satisfaction, are needed to increase our understanding of factors associated with the outcomes.

摘要

引言:阴茎再造术是一项复杂的手术,必须满足功能和美学要求。这是一个漫长且要求苛刻的手术过程,其最后阶段包括植入可用于重现勃起功能的刚性或可膨胀材料。文献中的数据稀少,仅有开创性的系列报道,其中包括首批器械和技术的使用情况。 目的:报告采用标准化手术技术植入勃起装置后阴茎成形术患者的治疗结果,以及使用或未使用血管移植物的新型假体的应用情况。 方法:这是一项基于医院的回顾性分析,纳入了2007年3月至2015年5月期间所有接受阴茎成形术并植入勃起假体的患者。通过多因素逻辑回归分析研究与并发症相关的因素。 主要观察指标:早期(术后第一个月内)和晚期并发症,包括侵蚀、感染、位置异常和功能障碍。 结果:本研究共纳入69例患者,分析了95例手术。中位随访4年(最短169天,最长6.1年)后,43例患者(62.3%)的原假体仍在位。患者接受阴茎成形术的原因包括男变女变性手术(n = 62,89.9%)、畸形(n = 4,5.8%)或创伤(n = 3,4.3%)。不同类型阴茎成形术的比例分别为:前臂游离皮瓣阴茎成形术58%(n = 40)、耻骨上阴茎成形术33.3%(n = 23)、其他类型7%(n = 6)。使用的勃起假体包括两件式AMS Ambicor(n = 71,74.7%)、带血管移植物的Ambicor(n = 19,20.0%)以及AMS 700CXR、AMS 700CX或AMS600 - 650(n = 5,5.2%)。89例手术(93.7%)无早期并发症,若有早期并发症,均与感染有关(n = 4,4.2%)。晚期并发症包括侵蚀(n = 4,4.2%)、感染(n = 4,4.2%)、功能障碍(n = 10,10.5%)和位置异常(n = 12,12.6%)。AMS Ambicor假体与带血管移植物的Ambicor假体在位置异常(12.7%对10.5%,P = 0.87)和功能障碍(7.0%对10.5%,P = 0.78)方面未观察到显著差异。 结论:本研究提供了勃起装置植入术后并发症的最新数据。需要开展多中心研究,包括评估患者满意度,以增进我们对与治疗结果相关因素的理解。

相似文献

[1]
Surgical Outcomes of Erectile Implants After Phalloplasty: Retrospective Analysis of 95 Procedures.

J Sex Med. 2016-11

[2]
The Rise of the Neophallus: A Systematic Review of Penile Prosthetic Outcomes and Complications in Gender-Affirming Surgery.

J Sex Med. 2019-4-5

[3]
Surgical Experience and Outcomes of Implantation of the ZSI 100 FtM Malleable Penile Implant in Transgender Men After Phalloplasty.

J Sex Med. 2019-10-31

[4]
First Outcomes of the ZSI 475 FtM, a Specific Prosthesis Designed for Phalloplasty.

J Sex Med. 2019-1-9

[5]
Erectile implants in female-to-male transsexuals: our experience in 129 patients.

Eur Urol. 2009-3-10

[6]
Surgical outcomes and patients' satisfaction with suprapubic phalloplasty.

J Sex Med. 2013-9-12

[7]
Penile implantation in Europe: successes and complications with 253 implants in Italy and Germany.

J Sex Med. 2008-6

[8]
A Retrospective Cohort Study on Surgical Outcomes of Penile Prosthesis Implantation Surgery in Transgender Men After Phalloplasty.

Urology. 2019-6-21

[9]
Inflatable penile prosthesis implantation after gender affirming phalloplasty with radial forearm free flap.

Int J Impot Res. 2019-6-6

[10]
Penile Prostheses.

Clin Plast Surg. 2018-7

引用本文的文献

[1]
The outcomes of inflatable penile prosthesis implantation in the context of Genital Gender Affirming Surgery in Assigned Female At Birth patients: A comparative study between cis-male Dacron modified and Zephyr Surgical Implants 475 Female To Male Penile Prosthesis.

Int J Impot Res. 2025-7-23

[2]
Current devices, outcomes, and pain management considerations in penile implant surgery: an updated review of the literature.

Asian J Androl. 2024-7-1

[3]
Penile and testicular prosthesis following gender-affirming phalloplasty and scrotoplasty: a narrative review and technical insights.

Transl Androl Urol. 2023-10-31

[4]
Insertion of inflatable penile prosthesis in the neophallus of assigned female at birth individuals: a systematic review of surgical techniques, complications and outcomes.

Ther Adv Urol. 2023-9-14

[5]
Functional and surgical outcomes after phalloplasty in cis men.

World J Urol. 2022-11

[6]
Penile Prosthesis in Transgender Men after Phalloplasty.

Indian J Plast Surg. 2022-7-14

[7]
Narrative review of penile prosthetic implant technology and surgical results, including transgender patients.

Transl Androl Urol. 2021-6

[8]
The Frontier of Penile Implants in Phalloplasty: Is the ZSI 475 FTM what we have been waiting for?

Int J Impot Res. 2020-11

[9]
Penile Cancer: Managing Sexual Dysfunction and Improving Quality of Life After Therapy.

Curr Urol Rep. 2021-1-9

[10]
Review of penile reconstructive techniques.

Int J Impot Res. 2021-4

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