Hage J J, Taets van Amerongen A H, Van Diest P J
Department of Plastic and Reconstructive Surgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
J Urol. 1999 Feb;161(2):467-71. doi: 10.1016/s0022-5347(01)61925-6.
Rupture of the envelope of silicone gel filled testicular prostheses is rare and alleged to be unlikely without intraoperative needle puncture. We observed that it may be caused by chronic intermittent trauma or a single acute increase of pressure, and report diagnostic and therapeutic modalities.
Four cases treated by us during the last 10 years are presented. One patient had testicular implants for Klinefelter's syndrome, whereas the other 3 had been treated for female-to-male transsexualism. Diagnosis was confirmed by ultrasonography and magnetic resonance imaging. The fibrous capsule surrounding the ruptured prosthesis was left intact to allow en bloc surgical extirpation. Histological evaluation of the resected specimen was performed.
Rupture of silicone gel filled testicular implants may be caused by acute or chronic pressure without intraoperative needle puncture.
Magnetic resonance imaging offers superior diagnostic accuracy and should be regarded the gold standard in the evaluation of implant rupture. Ultrasonography is an acceptable alternative. In cases when gross symptoms of scrotal inflammation are lacking replacement of implants is facilitated by the fibrous capsule that forms around any prosthesis. Transcapsular migration of silicone particles was observed even when the fibrous capsule was intact.
硅胶填充睾丸假体包膜破裂罕见，据称若无术中针刺则不太可能发生。我们观察到它可能由慢性间歇性创伤或单次急性压力增加引起，并报告诊断和治疗方式。
介绍我们在过去10年中治疗的4例病例。1例患者因克兰费尔特综合征植入睾丸假体，另外3例因女性变男性易性癖接受治疗。通过超声和磁共振成像确诊。破裂假体周围的纤维包膜保持完整，以便进行整块手术切除。对切除标本进行组织学评估。
硅胶填充睾丸植入物破裂可能由急性或慢性压力导致，而无术中针刺。
磁共振成像具有更高的诊断准确性，应被视为评估植入物破裂的金标准。超声检查是一种可接受的替代方法。在缺乏阴囊炎症明显症状的情况下，假体周围形成的纤维包膜便于更换植入物。即使纤维包膜完整，也观察到硅胶颗粒的跨包膜迁移。
