Shah Bhavik B, Kent Marissa, Valenzuela Robert
Advanced Urology, Snellville, GA, USA.
Department of Urology, Mount Sinai Hospital, New York, NY, USA.
Sex Med Rev. 2021 Oct;9(4):641-649. doi: 10.1016/j.sxmr.2020.05.007. Epub 2020 Jul 9.
The most common cause of patient dissatisfaction after penile prosthesis placement is penile shortening compared with one's memory of a natural erection. Surgical techniques as well as preoperative and postoperative protocols have been reported to preserve and possibly enhance penile length in someone undergoing penile prosthesis surgery.
This article presents a description of as well as the authors' experience with presurgical protocols, intraoperative techniques, and postsurgical protocols that allow for preservation or enhancement of penile length for patients who undergo inflatable penile prosthesis insertion.
An extensive, systematic literature review was performed using PubMed searching for key terms including penile lengthening, inflatablepenile prosthesis, penile girth, buried penis, and penile enhancement. All articles with subjective and/or objective penile length outcomes were reviewed.
Several preoperative treatment protocols were found for penile length preservation and enhancement, which included use of a vacuum erection device as well as traction therapy. Intraoperative techniques included cavernosal sparing, channeling without dilatation, circumferential penile degloving, ventral phalloplasty, suprapubic lipectomy, liposuction, suspensory ligament release, sliding technique, modified sliding technique, multislice technique, and aggressive implant sizing. Postoperative protocols included early device inflation and cycling. Table 1 summarizes and compares the various preoperative, intraoperative, and postoperative strategies identified during literature review with their corresponding reported length gain.
Many preoperative, intraoperative, and postoperative surgical techniques can be performed by high-volume implanters to improve one's perceived or true penile length. In the hands of experienced, high-volume implanters, these techniques can be very meaningful for patients undergoing penile prosthesis insertion, particularly those who are concerned with penile length. Shah B, Kent M, Valenzuela R. Advanced Penile Length Restoration Techniques to Optimize Penile Prosthesis Placement Outcomes. Sex Med Rev 2021;9:641-649.
阴茎假体植入术后患者不满的最常见原因是与自身记忆中的自然勃起相比阴茎缩短。据报道，手术技术以及术前和术后方案可在接受阴茎假体手术的患者中保留并可能增加阴茎长度。
本文介绍了术前方案、术中技术和术后方案，并分享了作者在为接受可膨胀阴茎假体植入的患者保留或增加阴茎长度方面的经验。
使用PubMed进行了广泛、系统的文献综述，搜索关键词包括阴茎延长、可膨胀阴茎假体、阴茎周长、埋藏阴茎和阴茎增大。对所有具有主观和/或客观阴茎长度结果的文章进行了综述。
发现了几种用于保留和增加阴茎长度的术前治疗方案，包括使用真空勃起装置以及牵引治疗。术中技术包括保留海绵体、无扩张通道、阴茎环形脱套、阴茎腹侧成形术、耻骨上脂肪切除术、抽脂、悬韧带松解、滑动技术、改良滑动技术、多层技术和积极的植入物尺寸选择。术后方案包括早期装置充气和循环。表1总结并比较了文献综述中确定的各种术前、术中和术后策略及其相应报告的长度增加。
经验丰富的大量植入手术医生可以采用多种术前、术中和术后手术技术来改善患者主观感知或实际的阴茎长度。在经验丰富的大量植入手术医生手中，这些技术对于接受阴茎假体植入的患者，尤其是那些关注阴茎长度的患者，可能非常有意义。沙阿B、肯特M、巴伦苏埃拉R。优化阴茎假体植入效果的先进阴茎长度恢复技术。性医学评论2021；9：641-649。
