Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands; Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Urology. 2019 Oct;132:195-201. doi: 10.1016/j.urology.2019.06.010. Epub 2019 Jun 21.
To assess surgical outcomes of penile prosthesis implantation in transgender men who underwent phalloplasty.
Transgender men who underwent penile prosthesis implantation after phalloplasty between January 1989 and September 2018 were retrospectively identified. A chart study was performed recording patient demographics, perioperative complications, and reoperations.
A total of 32 patients were identified: 22 underwent free radial forearm flap, 5 anterolateral thigh, 4 anterolateral thigh/free radial forearm flap, and 1 fibular flap phalloplasty. The median age at prosthesis implantation was 36 (range 21-59) years, the mean BMI 25.9 ± 4.0 kg/m. At first implantation, 16 inflatable (AMS Dynaflex (n = 13), AMS Ambicor (n = 3)) and 16 malleable (Coloplast genesis (n = 14), AMS Spectra (n = 2)) prostheses were placed. Of these, 5 (16%) were removed/replaced because of infection, 2 (6%) because of leakage, 2 because of extrusion, 2 because of dislocation, 2 because of dysfunction, and 1 (3%) because of pain. The postoperative course was completely uneventful in 10 (31.3%) patients. Of all implanted prostheses, including revision procedures (n = 45), 21 (44%) were surgically replaced or removed.
Prosthesis explantation, replacement, or revision surgery occurs frequently after penile prosthesis implantation. Patients need to be well-informed preoperatively on these complication rates.
评估接受过阴茎成形术的跨性别男性行阴茎假体植入术的手术结果。
回顾性分析 1989 年 1 月至 2018 年 9 月间接受阴茎假体植入术的跨性别男性患者。对患者的人口统计学数据、围手术期并发症和再次手术进行了图表研究。
共确定了 32 名患者：22 例行游离桡侧前臂皮瓣，5 例行股前外侧皮瓣，4 例行股前外侧皮瓣/游离桡侧前臂皮瓣，1 例行腓骨皮瓣阴茎成形术。假体植入时的中位年龄为 36 岁（范围 21-59 岁），平均 BMI 为 25.9±4.0kg/m2。初次植入时，16 例为可膨胀假体（AMS Dynaflex[n=13]，AMS Ambicor[n=3]），16 例为可弯曲假体（Coloplast genesis[n=14]，AMS Spectra[n=2]）。其中，5 例（16%）因感染、2 例（6%）因渗漏、2 例因脱出、2 例因脱位、2 例因功能障碍、1 例（3%）因疼痛而被取出/更换。10 例（31.3%）患者术后过程完全无并发症。包括修正手术在内，所有植入的假体中有 21 例（44%）被手术取出或更换。
阴茎假体植入后，假体取出、更换或修正手术的发生率较高。患者需要在术前充分了解这些并发症的发生率。
