Institute of Andrology, Department of Urology, University College London Hospitals NHS Trust, London, UK.
Division of Surgery and Interventional Science, UCL, London, UK.
Int J Impot Res. 2022 Aug;34(5):495-500. doi: 10.1038/s41443-021-00452-5. Epub 2021 Jul 20.
The aim of this study is to describe the outcomes for a modified glans-resurfacing technique for benign and malignant penile conditions in which the uninvolved glans corona is preserved in order to maintain glans erogenous sensation. A total of 13 patients underwent coronal-sparing glans resurfacing (CSGR), with follow-up every 3 months for ≥2 years. Positive surgical margin and local recurrence (LR) rates were evaluated. Surgical complications and cosmetic outcomes were also recorded. Patients were asked to complete the International Index of Erectile Function-5 (IIEF-5) questionnaire starting 12 months after the surgery. The median (interquartile range [IQR]) age and follow-up periods were 63 (53-68) years and 29 (14-38) months, respectively. Eight patients were diagnosed with primary penile squamous cell carcinoma (SCC), three had refractory lichen sclerosus, and two had penile intraepithelial neoplasia (PeIN). No surgical complications were recorded. All patients had a complete graft take and reported satisfactory cosmetic results with preserved erogenous sensation. Two cancer patients developed LR which was managed with further penile preserving surgery. The median (IQR) postoperative IIEF-5 value was 20 (17-23). This modified coronal-sparing technique was suitable for glans lesions that spare the coronal ridge and coronal sulcus. Preservation of the coronal ridge helps maintain sexual function and provides excellent cosmetic outcomes.
本研究旨在描述一种改良的阴茎头表面重建技术的结果，该技术用于治疗良性和恶性阴茎病变，同时保留未受累的阴茎冠状沟以维持龟头性感觉。共有 13 名患者接受了冠状沟保留的阴茎头表面重建（CSGR），随访时间≥2 年，每 3 个月随访一次。评估了切缘阳性和局部复发（LR）率。还记录了手术并发症和美容结果。患者在手术后 12 个月开始完成国际勃起功能指数-5（IIEF-5）问卷。中位（四分位间距[IQR]）年龄和随访时间分别为 63（53-68）岁和 29（14-38）个月。8 例患者被诊断为原发性阴茎鳞状细胞癌（SCC），3 例为难治性硬化性苔藓，2 例患有阴茎上皮内瘤变（PeIN）。未记录到手术并发症。所有患者均完全接受了移植物，并报告了保留性感觉的满意美容效果。2 例癌症患者发生 LR，通过进一步的阴茎保留手术进行了处理。术后 IIEF-5 的中位数（IQR）为 20（17-23）。这种改良的冠状沟保留技术适用于冠状沟保留的龟头病变。冠状沟的保留有助于维持性功能并提供出色的美容效果。
