Department of Plastic, Reconstructive, Aesthetic, and Maxillofacial Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
Department of Plastic, Reconstructive, Aesthetic, and Maxillofacial Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
J Plast Reconstr Aesthet Surg. 2022 May;75(5):1529-1536. doi: 10.1016/j.bjps.2021.11.116. Epub 2022 Jan 31.
Vascularized composite allotransplantation has become an alternative reconstruction technique for patients with a severe loss of substance. Today, five human penile transplantations have been reported. The objective of this literature review is to offer an updated overview of the technical and ethical questions surrounding penile transplantation compared with conventional phalloplasty.
A systematic review was conducted of the literature from 2000 to 2020. A search of PubMed was performed using the keywords: "penile transplantation," "penis transplantation," and "penile vascularized composite allotransplantation." The criteria for the analysis were the type of study, surgical techniques, and ethical concerns.
Thirty-six articles were selected. These articles include reviews, case report, editorials, and preclinical studies. The first article was published in 2003, but the number of articles has increased after the second human transplantation in South Africa in 2014. Surgical techniques and the medication management specific to each team were successful in the 5 transplant cases, but several complications were noted.
Two decades of successful penile transplantations have proven the technique to be a viable solution to treat a penile amputation, allowing for a better esthetic and sensitive outcome paired with the possibility of natural urinary and erectile functions. Psychological impact of penile transplantation, selection of patients, complications of immunosuppressive therapies, and surgical technicity are the biggest penile transplantation challenges. Further experimental studies are necessary to produce standardized protocols to safely include penile transplantation in the conventional treatment of a penile amputation.
血管化复合组织同种异体移植已成为严重组织缺损患者的一种替代重建技术。目前已有 5 例人类阴茎移植报道。本文旨在对阴茎移植与传统阴茎成形术相关的技术和伦理问题进行综述，为其提供最新的概述。
对 2000 年至 2020 年的文献进行系统综述。在 PubMed 上使用“penile transplantation”“penis transplantation”和“penile vascularized composite allotransplantation”等关键词进行搜索。分析标准为研究类型、手术技术和伦理问题。
共选择 36 篇文章，包括综述、病例报告、社论和临床前研究。第一篇文章发表于 2003 年，但在 2014 年南非进行第二例人体移植后，文章数量有所增加。5 例移植病例的手术技术和每个团队特定的药物管理均取得成功，但也出现了一些并发症。
20 年来成功的阴茎移植证明，该技术是治疗阴茎离断的可行方法，可获得更好的美学和敏感效果，并可能恢复自然的尿和勃起功能。阴茎移植的心理影响、患者选择、免疫抑制治疗的并发症以及手术技术是阴茎移植面临的最大挑战。需要进一步的实验研究来制定标准化方案，以安全地将阴茎移植纳入常规阴茎离断治疗。
