Shaeer Osama, Abdel Rahman Islam Fathy Soliman, Shaeer Kamal
Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.
Sex Med. 2019 Sep;7(3):357-360. doi: 10.1016/j.esxm.2019.06.002. Epub 2019 Jul 8.
In cases of explantation and delayed reimplantation of an infected penile prosthesis, the scarring that afflicts the corporal bodies renders reimplantation difficult and risky, with potential loss in penile size.
Mitomycin C is an antitumor, antibiotic agent with a potent antifibrotic action that can be used to limit corporal scarring following explantation with the aim of achieving easy and safe subsequent reimplantation, in addition to preserving penile size.
This was a prospective study involving 5 patients with infected penile prostheses who were referred to our tertiary implantation center. The infected prostheses were explanted, followed by corporal washout with antiseptics and antibiotics. Patients were rescrubbed and redraped. Mitomycin C, 10 mg in 250 cc saline, was instilled into the corpora cavernosa (125 cc each), avoiding extracavernous spilling and contact with corporotomy and skin edges. Corporotomy and skin edges were freshened and closed. Reimplantation was performed 10 to 12 weeks later.
We evaluated the ease of blunt dilatation upon reimplantation and success in implanting cylinders the same size as the ones explanted.
We were able to dilate the corporal bodies with ease in all cases using blunt Hegar dilators. All cases received the same size implant as the one explanted, in terms of length and girth, with the exception of a case where the length was only 1 cm shorter.
Irrigation of the cavernous spaces with mitomycin C upon explantation of an infected penile prosthesis appears to ameliorate corporal scarring and keep the cavernous spaces open. On a larger scale, this approach could render the most feared complication of penile prosthesis implantation surgery much more manageable. Shaeer O, Abdel Rahman IFS, Shaeer K. Shaeer's Anti-Scarring Technique: A Preventive Measure Against Corporal Fibrosis Upon Explantation of Infected Penile Implants. Sex Med 2019; 7:357-360.
在感染性阴茎假体取出及延迟再植入的病例中，阴茎海绵体的瘢痕形成会使再植入困难且具有风险，可能导致阴茎尺寸减小。
丝裂霉素C是一种具有强大抗纤维化作用的抗肿瘤抗生素药物，可用于限制假体取出后阴茎海绵体的瘢痕形成，以期在后续再植入时简便安全，同时保持阴茎尺寸。
这是一项前瞻性研究，纳入了5例因感染性阴茎假体被转诊至我们三级植入中心的患者。取出感染的假体，随后用防腐剂和抗生素冲洗海绵体。患者重新进行皮肤消毒铺巾。将10mg丝裂霉素C溶于250cc生理盐水中，分别向双侧阴茎海绵体注入125cc，避免海绵体外渗漏以及与阴茎海绵体切口和皮肤边缘接触。修整阴茎海绵体切口和皮肤边缘后缝合。10至12周后进行再植入。
我们评估了再植入时钝性扩张的难易程度以及成功植入与取出假体尺寸相同的圆柱体的情况。
在所有病例中，我们均能够使用钝头黑加耳扩张器轻松扩张阴茎海绵体。除1例长度仅短1cm外，所有病例植入的假体在长度和周长方面与取出的假体尺寸相同。
感染性阴茎假体取出时用丝裂霉素C冲洗海绵体腔似乎可减轻海绵体瘢痕形成并保持海绵体腔开放。从更大范围来看，这种方法可使阴茎假体植入手术最令人担忧的并发症更易于处理。沙伊尔·O、阿卜杜勒·拉赫曼·IFS、沙伊尔·K。沙伊尔抗瘢痕技术：感染性阴茎植入物取出时预防海绵体纤维化的措施。《性医学》2019年；7：357 - 360。
