Kashiyama Kazuya, Nakano Motoi, Higashi Akihito, Ashizuka Shoko, Moriuchi Yuki, Iwao Atsuhiko, Tanaka Katsumi
Department of Plastic and Reconstructive Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan.
Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan.
Case Rep Urol. 2022 Mar 19;2022:2808821. doi: 10.1155/2022/2808821. eCollection 2022.
The scrotum functions to maintain spermatogenesis and hormonal production of Leydig cells by preventing the testicles from rising in temperature and protecting them from the outside world. The scrotum, along with the penis, is also an organ that symbolizes masculinity. Therefore, deformity or loss of the scrotum can be a major psychological problem. Various scrotal reconstruction techniques have been reported. In these papers, there is some discussion about the type of skin flap, but little discussion about the method of suturing the skin flap. We devised a way to reconstruct a scrotum to a natural size by suturing two skin flaps together to form a ball shape. . Case 1 was a patient with a missing scrotum due to Fournier's gangrene. Total resection of the scrotum, including the bilateral testes, was performed to save his life. Reconstructive surgery was performed 11 days after the initial surgery. Reconstruction was performed using bilateral gluteal fold flaps. Case 2 was a patient with a congenital defect of the scrotum. The testis on the right side exhibited cryptorchidism, and the scrotum was missing, and the testis on the left side was encased in a hypoplastic scrotum. Reconstruction was performed using an internal pudendal artery perforator flap.
There are two types of scrotal defects: those with testes present and those with testes missing. This method can be used for both types of scrotal defects, and we were able to create a scrotum that satisfied each patient.
阴囊通过防止睾丸温度升高并保护其免受外界影响，来维持精子发生和睾丸间质细胞的激素分泌。阴囊与阴茎一样，也是象征男性气质的器官。因此，阴囊畸形或缺失可能会成为一个主要的心理问题。已经报道了各种阴囊重建技术。在这些论文中，对皮瓣类型有一些讨论，但对皮瓣缝合方法的讨论很少。我们设计了一种方法，通过将两个皮瓣缝合在一起形成球形，将阴囊重建到自然大小。病例1是一名因福尼尔坏疽导致阴囊缺失的患者。为挽救其生命，对包括双侧睾丸在内的阴囊进行了全切除。在初次手术后11天进行了重建手术。使用双侧臀褶皮瓣进行重建。病例2是一名阴囊先天性缺陷患者。右侧睾丸隐睾，阴囊缺失，左侧睾丸包裹在发育不全的阴囊内。使用阴部内动脉穿支皮瓣进行重建。
阴囊缺损有两种类型：有睾丸的和无睾丸的。这种方法可用于两种类型的阴囊缺损，并且我们能够为每个患者造出一个令人满意的阴囊。
