Fraiman Elad, Nandwana Devika, Loria Matthew, Chambers Kelly, Rhodes Stephen, Pope Rachel, Scarberry Kyle, Gupta Shubham, Mishra Kirtishri
Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals, Urology Institute, Cleveland, OH.
Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals, Urology Institute, Cleveland, OH.
Urology. 2024 Dec;194:260-268. doi: 10.1016/j.urology.2024.08.022. Epub 2024 Aug 25.
To synthesize current literature on penile prosthesis implantation post-gender affirming phalloplasty to correlate implant types and complication rates.
A meta-analysis of penile prosthesis in transmasculine patients was initiated in December 2022. Inclusion criteria encompassed randomized clinical trials, cohort studies, and cross-sectional studies reporting on penile prosthesis complications post-gender-affirming phalloplasty. Exclusion criteria were review articles, meta-analyses, studies that exclusively reported on cisgender patients or surgeries other than penile prosthesis implantation. An initial search of 5 databases yielded a total of 1593 articles. Upon screening, 15 full-text articles were eligible for inclusion. Nine studies were included in the analysis.
The overall complication rate for the inflatable prosthesis group was 38% (95% CI: 21, 59) and for the malleable prosthesis group was 37% (95% CI: 18, 62). The most probable complications in the inflatable group were infection (14.5%), dysfunction (12.9%), dislocation (5.7%), and leakage (5.4%). The most probable complications in the malleable group were dislocation (14.9%), infection (11.2%), dysfunction (9.1%), and extrusion (7.6%). There was no significant difference in the probability of any complications between the malleable and inflatable prosthesis groups. The best estimate of explantation rates for any reason for the inflatable group was 19% (95% CI: 9, 38) and for the malleable group 13% (95% CI: 4, 33). There was no significant difference in the probability of any reason for explantation between the malleable and inflatable prosthesis groups.
综合当前关于性别确认阴茎成形术后阴茎假体植入的文献，以关联植入类型和并发症发生率。
2022年12月启动了一项关于阴茎假体在跨性别男性患者中的荟萃分析。纳入标准包括随机临床试验、队列研究和横断面研究，这些研究报告了性别确认阴茎成形术后阴茎假体的并发症。排除标准为综述文章、荟萃分析、仅报告顺性别患者或阴茎假体植入以外手术的研究。对5个数据库进行初步检索共得到1593篇文章。经筛选，15篇全文文章符合纳入条件。9项研究纳入分析。
可膨胀假体组的总体并发症发生率为38%（95%置信区间：21，59），可弯曲假体组为37%（95%置信区间：18，62）。可膨胀组最可能的并发症是感染（14.5%）、功能障碍（12.9%）、脱位（5.7%）和渗漏（5.4%）。可弯曲组最可能的并发症是脱位（14.9%）、感染（11.2%）、功能障碍（9.1%）和外露（7.6%）。可弯曲假体组和可膨胀假体组在任何并发症发生概率上无显著差异。可膨胀组因任何原因的取出率最佳估计为19%（95%置信区间：9，38），可弯曲组为13%（95%置信区间：4，33）。可弯曲假体组和可膨胀假体组在因任何原因取出的概率上无显著差异。
