Clinical study of novel glanuloplasty based on retrograde design method in phalloplasty
10.3760/cma.j.cn114453-20221214-00382
- VernacularTitle:基于逆行设计方法的阴茎头成形术在阴茎再造中的临床应用
- Author:
Zilong CAO
1
;
Zhe YANG
;
Yangqun LI
;
Ning MA
;
Liqiang LIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院瘢痕与创面治疗一科，北京 100144
- Keywords:
Penis;
Glanuloplasty;
Retrograde design;
Anterolateral thigh flap
- From:
Chinese Journal of Plastic Surgery
2023;39(6):621-627
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical value and effect of the application of a three-dimensional retrograde design method to improve glanuloplasty.Methods:Patients treated with novel glanuloplasty from April 2019 to March 2022 in the Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Before the operation, a normal penis model was constructed in vitro by a three-dimensional retrograde design method. Copy and rub the shape of the neopenis, which was divided into four parts: head, neck, body, and tail. During the operation, the "arrow" anterolateral thigh (ALT) flap was harvested to construct the neoglans and urethra, the bilateral gracilis muscles and fascia lata were assembled to construct the penile shaft, and free skin graft acted as the foreskin to cover the wound. The appearance and touch of the neoglans, the change in the length and circumference of the neopenis, and the patient’s satisfaction were evaluated.Results:Five patients were enrolled, with an average of 23.4 (20-32) years. Among them, 3 cases were diagnosed as perineal hypospadias, 1 case was congenital micropenis, and 1 case was traumatic penile absence. All the neoglans survived well after the operation, and the meatus of the urethra was located at the top of the neopenis. The donor sites could be sutured primarily without skin grafting. All patients underwent secondary urethral anastomosis 6-9 months after the first stage. Follow-up for 6-12 months after the operation showed that the neoglans had no deformation and the tactile sensation had recovered well. All patients were satisfied with the color, size, and appearance of the neoglans. The neopenis could contract spontaneously about 6 months after the operation, get erection and maintain a certain hardness. The length and circumference of the neopenis decreased to a certain extent within 3 months after the operation, but it was stable at 6 months. The change rate of length was -10.34% to -25.00%, and the change rate of circumference was -5.88% to -13.89%. All patients could urinate in the standing position, and the urine line was normal after the second stage of urethral anastomosis.Conclusion:Based on the concept of retrograde flap design, the "arrow-shaped" ALT flap can construct vivid neoglans and obtain a good prognosis in clinical practice. This technique is easy to operate and can be used for preoperative three-dimensional simulation of body surface organs.
