Reddy Soumya A, Crane Curtis N, Safir Michael, Santucci Richard A
Texas Tech Health Sciences Center School of Medicine, Lubbock, Tex.
Crane Center for Transgender Surgery, Austin, Tex.
Plast Reconstr Surg Glob Open. 2022 Jul 22;10(7):e4433. doi: 10.1097/GOX.0000000000004433. eCollection 2022 Jul.
Construction of the glans is an important aspect of gender-affirming phalloplasty. In these surgeries, the glans ridge is commonly constructed using the Norfolk technique or a similar technique. In cases of glans ridge flattening after creation, we generally recommend a redo/revision glansplasty, which is often curative. However, in situations when the glans ridge flattens again, we developed a silicone glans implant technique in an effort to create a satisfactory and lasting glans ridge.
We conducted a pilot study of our first 12 glans implant cases. A retrospective chart review and brief, ad-hoc patient survey measured patient demographics, implant status, and patient satisfaction.
A total of 12 patients received a silicone glans implant between November 2017 and February 2020. One patient had the glans implant removed before the survey, and also could not be contacted. Three patients did not respond to the survey. Of the eight patients who responded, only five (5/8, 63%) patients still had the silicone implant at the time of the survey. The average satisfaction score was 3.25 (range 1 = very satisfied and 5 = very dissatisfied). Common complaints cited included dissatisfaction with implant appearance, as well as infection, discomfort, and pain.
Patients and surgeons should be aware of the possibility of a novel silicone implant technique to create a glansplasty in those with failed/flattened previous glansplasty surgery. However, the technique is in development: patient satisfaction remains spotty and complication rates are high, although technical improvements may increase future success rates.
阴茎头构建是性别肯定性阴茎成形术的一个重要方面。在这些手术中，阴茎头嵴通常采用诺福克技术或类似技术构建。在构建后阴茎头嵴变平的情况下，我们一般建议进行再次手术/阴茎头成形术修复，这通常是有效的。然而，在阴茎头嵴再次变平的情况下，我们开发了一种硅胶阴茎头植入技术，以努力创建一个令人满意且持久的阴茎头嵴。
我们对最初的12例阴茎头植入病例进行了一项试点研究。通过回顾性病历审查和简短的临时患者调查来衡量患者的人口统计学特征、植入物状况和患者满意度。
2017年11月至2020年2月期间，共有12例患者接受了硅胶阴茎头植入。1例患者在调查前取出了阴茎头植入物，且无法取得联系。3例患者未回复调查。在回复的8例患者中，只有5例（5/8，63%）在调查时仍保留硅胶植入物。平均满意度评分为3.25（范围为1 = 非常满意，5 = 非常不满意）。常见的抱怨包括对植入物外观不满意，以及感染、不适和疼痛。
患者和外科医生应意识到在先前阴茎头成形术失败/变平的患者中采用新型硅胶植入技术来进行阴茎头成形术的可能性。然而，该技术仍在发展中：患者满意度参差不齐，并发症发生率较高，尽管技术改进可能会提高未来的成功率。
