Selection of balanoplasty in penile reconstruction
10.3760/cma.j.cn114453-20191111-00339
- VernacularTitle:阴茎再造术中阴茎头成形方案的选择
- Author:
Hengxin LIU
1
;
Yulin DONG
;
Chaohua LIU
;
Liwei DONG
;
Dongyue HAO
;
Wensen XIA
Author Information
1. 空军军医大学西京医院全军整形外科研究所，西安 710032
- Keywords:
Penis;
Surgical flap;
Transplants;
Penile reconstruction;
Balanoplasty;
Costal cartilage;
Transplantation, glans penis
- From:
Chinese Journal of Plastic Surgery
2020;36(8):866-871
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the strategy of balanoplasty in penile reconstruction with free forearm flap.Methods:From October 2010 to October 2015, 20 patients (19-41 years old) underwent penile reconstruction with free forearm skin flap in Xijing Hospital of Air Force Military Medical University, including 14 cases of transexuals (female to male), 3 cases of hermaphroditism, 2 cases of congenital penile dysplasia and 1 case of penile defect after trauma. According to the tissue quantity of forearm flap and the development of glans, three methods were adopted to reconstruct the glans: free forearm skin flap + E-shaped cartilage framework, free dorsalis pedis flap + E-shaped cartilage framework or free glans transplantation. The patients were followed up for a long time postoperation to observe the morphological changes of the glans after different method of balanoplasty.Results:Among the 20 patients, 18 cases were treated with distal part of free forearm flap and E-shaped cartilage framework for glans reconstruction, 1 case of transexuals used free dorsalis pedis flap and E-shaped cartilage framework for glans reconstruction, and 1 case of hermaphroditism used free glans transplantation to reconstruct glans. After 10-36 months of follow-up, all reconstructed penises survived. The shape of glans reconstructed by dorsalis pedis flap was the most plump and natural with clear coronal sulcus; the amount of glans tissue reconstructed by forearm skin flap was slightly insufficient, and the coronal sulcus was slightly flat, while the overall shape was satisfactory. The reconstructive glans with free glans transplantation was not plump, but they retained the shape of glans, which was lifelike.Conclusions:If the tissue quantity of forearm skin flap is sufficient, the distal part of free forearm flap and E-shaped cartilage framework is used; if the tissue quantity of forearm is seriously insufficient, the free dorsalis pedis flap and E-shaped cartilage framework is used. For hermaphroditism patients with well-developed glans, autologous glans free transplantation is used.Individualized strategy of balanoplasty according to different conditions of patients is conducive to obtaining satisfactory appearance of the glans.
