阴茎纵形切口行阴茎延长术20例报告

目的：观察阴茎纵行切13成形阴茎延长术的临床效果。方法：采用阴茎纵行切口成形阴茎延长术治疗阴茎短小者20例。结果：术后所有患者均对手术效果满意,阴茎自然显露长度延长约3～5cm,勃起约4～8cm,随访2～3个月,无明显回缩,无脂肪液化和明显瘢痕形成,2例出现皮肤切口裂开,换成褥式缝合皮肤后再无发生,术后均有不同程度的包皮水肿,1～2个月后逐渐消退。手术平均时间约35min。结论：阴茎纵行切口成形阴茎延长术临床效果满意。     

肥胖成年阴茎延长术的临床体会

体形肥胖伴有阴茎短小的成年患者在临床上比较常见。笔者自1999年10月至2005年6月收治了13例阴茎短缩、类似隐匿阴茎的成年患者。采用阴茎悬韧带切断、阴阜脂肪切除、术后阴茎牵引等方法进行阴茎延长，效果满意。现报道如下。     

阴茎延长术35例体会

阴茎延长术已是成熟的外生殖器整形手术，简便易行，损伤小，功能好，适宜阴茎短小，影响夫妇生活质量，以及阴茎基本正常希望通过延长手术进一步提高性生活质量者。自2003年11月以来，我科行单纯阴茎延长手术35例，效果满意，总结如下。     

阴茎延长术的解剖与临床应用

目的探讨成人阴茎延长术的可行性和安全性。方法在20具正常男性成年人尸体阴茎延长解剖学观测的基础上,选择46例阴茎短小（2.8±1.2）cm（1.6～3.5 cm）患者,在阴茎根部设计＂N＂形切口,左、右径3.0～4.5 cm,保留皮瓣足够厚度和良好血运,从皮肤到阴茎浅韧带的厚度3.0～5.0 cm,直视或指感下完全切断阴茎浅韧带,将深韧带切断1/3,切口留置皮条引流。结果尸体解剖学观测,阴茎浅韧带在阴茎根部的厚度为（0.4±0.1）cm（0.2～0.7 cm）,宽度（3.1±0.9）cm（2.1～5.0 cm）。阴茎深韧带厚度为（2.5±1.0）cm（2.0～3.1 cm）,宽度（0.5±0.1）cm（0.4～0.6 cm）。46例术后测量阴茎自然静态下长度（4.6±1.5）cm（3.5～6.0 cm）,较手术前延长（2.5±0.7）cm（1.9～3.5 cm）,术后与术前比较差异有统计学意义（t=4.228,P=0.000）。3例术后阴茎水肿用1∶5000呋喃西林液浸泡3个月后消退。42例（91.3%）随访8个月～15年,平均6年2个月,〉5年31例,患者自信心增加、自觉性生活满意占85.7%（36/42）,另6例（14.3%）感到延长长度不够,仍不满意。结论切断阴茎浅韧带和部分深韧带行阴茎延长术安全有效,术后阴茎皮下顽固水肿与阴茎背浅静脉及淋巴管损伤有密切关系。     

悬韧带松解阴茎延长术后延长长度预测模型的建立和验证

目的 研究悬韧带松解阴茎延长术术后延长长度的个体化预测方法.方法 选取第三军医大学第一附属医院整形美容科1988年10月至2011年4月行悬韧带松解阴茎延长术的先天性阴茎发育不良病例322例,随机分为建模组(200例)与验证组(122例),将建模组手术前、后的常态与勃起状态阴茎长度等指标进行相关性或线性回归分析,并推导预测公式,通过建模组与验证组中预测结果与实际结果的一致性来评价预测效果.结果 患者术后常态与勃起状态的延长长度以及术前、术后阴茎由常态到勃起状态的伸长率存在显著的相关性(相关系数分别为0.921、0.803,P＜0.01),由此可推导出延长长度的预测公式,通过对建模组与验证组的数据进行检验,预测误差在±1.5 cm以内时其有效预测率分别为84.5％(169/200)和87.7％(107/122).结论 该预测公式可用于悬韧带松解阴茎延长术后延长长度的初步个体化预测.     

阴茎部分切除加阴茎延长术治疗阴茎癌

阴茎癌是一特殊部位的肿瘤,以手术治疗为主.手术治疗后阴茎受到破坏,从而不能性交和站立排尿.但近3年来我科对32例早期阴茎癌患者行阴茎部分切除加阴茎延长术后,门诊随访1年,既达到治疗目的,又保留性交能力,是一有效的治疗方法.     

耻骨上V-Y切口阴茎延长术与冠状沟环切口+耻骨上抽脂阴茎延长(Sun's)术比较

目的:评估耻骨上V-Y切口阴茎延长术与冠状沟环切口+耻骨上抽脂阴茎延长术(Sun's阴茎延长术)的临床效果。方法:回顾性分析我院由同一组医师所行阴茎延长术病例100例,其中V-Y切口阴茎延长术(V-Y组)50例;Sun's阴茎延长术50例,对两组的体质量指数、术前阴茎静态与勃起长度、术后阴茎静态及勃起长度、手术时间、出血量、住院时间、镇痛药物使用情况、伤口Ⅰ期愈合率及术后并发症等指标进行统计分析。结果:两组患者平均年龄分别为23.5岁和23.0岁、体质量指数分别为(26.59±1.16)kg/m~2和(26.44±0.96)kg/m~2、术前阴茎静态长度分别为(5.11±0.30) cm和(5.12±0.35) cm、勃起长度分别为(7.57±0.65)cm和(7.35±0.59) cm、术后阴茎静态长度分别为(7.80±0.40) cm和(7.79±0.42)cm、勃起长度长度分别为(11.59±0.55)cm和(11.47±0.64) cm,组间差异无统计学意义(P0.05),但V-Y组在手术时间[108(90～120)min]、术中出血量[30(15～45)ml]、住院时间[8(6～11)d]、术后镇痛药物使用率(26.67%)、血肿发生率(23.33%)和感染率(20.00%)均显著高于Sun's阴茎延长术组[51(45～58)min、15(5～25)ml、4(2～6)d、3.33%、0%、0%,P0.01或P0.05];伤口的Ⅰ期愈合率显著低于后者(76.67%vs 100.00%,P=0.016)。V-Y组和Sun's阴茎延长术组术前性生活质量评分分别为(28.70±4.87)分和(28.27±3.40)分,无统计学差异(P0.05);术后分别为(36.73±5.41)分和(42.07±3.64)分(P0.05),术后两组性生活质量评分均显著高于术前(P0.01),但Sun's阴茎延长术组术后性生活质量评分显著高于V-Y组(P0.01)。结论:Sun's阴茎延长术在治疗成人阴茎短小疾病中具有创伤小、手术时间短、出血量少,术后并发症发生率较低的特点,在临床上有较高应用价值。     

Penile length and circumference dimensions: A large study in young Italian men

The aim of the present study was to evaluate the size of the penis in flaccidity and in erection of Italian men. A total of 4,685 men living in Italy and who have been visited at the Italian urology operating units were involved in the study between January 2019 and January 2020. Each patient was given details on how to measure their penis (erect length and circumference) in flaccidity and in erection, from the lower base to the distal penile tip. Mean (standard deviation [SD]) flaccid penis length was 9.47 (2.69), mean (SD) flaccid penis circumference was 9.59 (3.08), mean (SD) erect penis length was 16.78 (2.55) and mean (SD) erect penis circumference was 12.03 (3.82). At the linear regression analysis, height was associated with flaccid penis length (β = 0.04; p-value = .01), and erect penis length was (β = 0.05; p-value < .01) and erect penis circumference was (β = 0.06; p-value < .01). Height is proportional to the length of the penis in flaccidity and in erection, and to the circumference in erection. The increase in BMI leads to a reduction in the length of the erect penis, as well as weight gain reduces the length of the flaccid penis.     

阴茎延长术后并发症的分析与防治

目的 探讨阴茎延长术后并发症的原因及防治方法，提高阴茎延长术的成功率及安全性。方法 回顾500例阴茎延长术，分析并发症出现的原因及阐述防治措施。结果 500例中并发症分别为：术后阴茎包皮水肿20例，皮瓣尖端坏死15例，血肿12例，伤口延迟愈合10例，感染9例，术后蹼状阴茎畸形8例。并发症总数为74例，发生率为14．8％。结论正确的手术方法。严格的无菌操作及术后护理，可以有效地防止或减少并发症的发生；一旦出现并发症，应及时正确地处理，多数仍可获得满意的效果。     

Suspensory ligament release combined with acellular dermal matrix filler in infrapubic space: A new method for penile length augmentation

Until now, no reliable method is recognised in treating buried penis. This study explored a new method of penile length augmentation using acellular dermal matrix filler in infrapubic space combined with liposuction and penile suspensory release. Patients with “small‐sized penis” received penile length augmentation procedure including suprapubic liposuction, penile suspensory ligament release and insertion of folded acellular dermal matrix between corpora cavernosa and pubis symphysis. Their penile length from tip to skin was measured pre‐operatively and post‐operatively. The post‐operative complications and patients' satisfaction were also recorded. Fifteen adult male patients were included with the mean age of 33.2 ± 4.6 years old and BMI of 28.9 ± 5.3 kg/m². The average amount of liposuction was 430 ± 90.0 ml. The average penile length measured pre‐operatively and post‐operatively (on table and 3 months afterwards) was 3.0 ± 1.3 cm, 7.3 ± 2.1 cm and 5.4 ± 1.8 cm. The penile length has significantly increased by 4.3 ± 1.6 cm (on table) and 2.4 ± 0.8 cm (3 months post‐operatively; p < 0.05). The post‐operative complications included oedema of penis, ecchymosis of lower abdomen and poor wound healing. No patient was dissatisfied with the appearance and function. The new method using acellular dermal matrix combined with liposuction and penile suspensory ligament release is safe and effective. The method could be applied to selected patients with buried penis.     

A pilot phase-II prospective study to test the 'efficacy' and tolerability of a penile-extender device in the treatment of 'short penis'

OBJECTIVE

To assess a commonly marketed brand of penile extender, the Andro‐Penis® (Andromedical, Madrid, Spain), widely used devices which aim to increase penile size, in a phase II single‐arm study powered to detect significant changes in penile size, as despite their widespread use, there is little scientific evidence to support their potential clinical utility in the treatment of patients with inadequate penile dimensions.

PATIENTS AND METHODS

Fifteen patients were required to test the efficacy of the device, assuming an effect size of >0.8. Eligible patients were counselled how to use the penile extender for at least 4 h/day for 6 months. Penile dimensions were measured at baseline and after 1, 3, 6 and 12 months (end of study). The erectile function (EF) domain of the International Index of EF was administered at baseline and at the end of the study. Treatment satisfaction was assessed using an institutional unvalidated five‐item questionnaire.

RESULTS

After 6 months the mean gain in length was significant, meeting the goals of the effect size, at 2.3 and 1.7 cm for the flaccid and stretched penis, respectively. No significant changes in penile girth were detected. The EF domain scores improved significantly at the end of study. Treatment satisfaction scores were consistent with acceptable to good improvement in all items, except for penile girth, where the score was either ‘no change’ or ‘mild improvement’.

CONCLUSIONS

Penile extenders should be regarded as a minimally invasive and effective treatment option to elongate the penile shaft in patients seeking treatment for a short penis.     

阴茎延长术并发症分析与处理

目的：分析总结阴茎延长术后并发症及其处理方法。方法：16例阴茎延长术后并发症包括感染、血肿、皮瓣坏死、包皮水肿和瘢痕增生等，应用手术、换药、理疗等分别进行了治疗。结果：16例并发症患者经不同方法治疗处理后均痊愈。结论：阴茎延长术后感染和皮瓣坏死者阴茎延长效果差，其他并发症对阴茎延长的效果影响较小。     

Penile length–somatometric parameters relationship in healthy Egyptian men

This study aimed to assess the penile length–somatometric parameters relationship in healthy Egyptian men. Two thousand physically normal men (22–40 years) were subjected to measurement of stretched penile length, glans penis, testis size, index finger, weight, height, span, body mass index (BMI), waist circumference, hip circumference and waist/hip ratio. The mean stretched penile length of the studied subjects was 13.84 ± 1.35 cm (range 12–19 cm), and the mean glans penis length was 2.6 ± 0.4 cm (range 1.7–3.8 cm). Penile length demonstrated positive significant correlation with glans penis length, index finger length, BMI and significant negative correlation with waist/hip ratio. On the other hand, penile length demonstrated nonsignificant correlation with age, weight, height, waist circumference, span or testicular size. It is concluded that the penile length‐somatometric parameters relationship in healthy Egyptian men is mostly related to glans penis and index finger lengths.     

Establishing a reference range for penile length in Caucasian British men: a prospective study of 609 men

Study Type – Diagnostic (validating cohort) Level of Evidence 2a What’s known on the subject? and What does the study add? Reference ranges for normal penile length have been reported from several different countries and anthropometric differences have been noted between different nationalities and ethnic backgrounds. This study describes one of the largest cohorts of men undergoing penile size measurements in Europe and the largest UK study. The range of measurements collected in this study will be of use to clinicians treating men with concerns over penile length, as well as helping to diagnose patients with true micropenis.

OBJECTIVES

? To establish a reference range for adult male genital size in the UK using penile length measurements. ? To compare the reference ranges for normal penile length reported from several different countries and the anthropometric differences noted between different nationalities and ethnic backgrounds.

METHODS AND MATERIALS

? Over 20 months, genital measurements were taken from all men undergoing routine examination in clinics (n= 499) and in operating theatres during examination under anaesthetic (n= 110). ? Using a rigid metric ruler three penile measurements were taken: flaccid pendulous penile length, flaccid penopubic penile length (to the pubic arch) and stretched flaccid penopubic length. In addition, testicular size was measured using an orchidometer. ? The patient’s age and the reason for referral were recorded. ? Statistical analysis was carried out using Pearson correlation analysis.

RESULTS

? Measurements from 610 patients aged 16–90 years were available for analysis. ? The mean penile lengths were: pendulous length 8.7 cm (sd 1.6 cm), penopubic length 10.2 cm (sd 1.4 cm) and stretched length 14.3 cm (sd 1.7 cm). The mean testicular volume was 19.8 mL (sd 5.4 mL) for both left and right testicles. ? Men with penile disease (including phimosis and Peyronie’s disease) had slightly reduced penile length (pendulous ?3.3 mm, P= 0.014; penopubic ?2.3 mm, P= 0.029; stretched ?5.1 mm, P < 0.001) compared with other referral groups (erectile dysfunction, testicular disease, prostate and bladder disease). ? There was no significant correlation between penile length and age or testicular size

CONCLUSION

? These data establish a reference range for adult male genital size in the UK, which should be helpful for urologists when counselling patients.     

包皮系带延长阴茎整形术在儿童隐匿阴茎治疗中的应用价值

目的 研究包皮系带延长阴茎整形术在儿童隐匿阴茎患者治疗中的应用价值。方法 选择2020年11月-2022年11月重庆市丰都县人民医院收治的60例隐匿阴茎患儿,按照随机数字表法分为对照组与观察组,各30例。对照组实施脱套固定手术治疗,观察组实施包皮系带延长阴茎整形术治疗,比较两组临床效果、手术指标、裸露阴茎平均长度、疼痛评分、并发症发生情况。结果 观察组治疗总有效率与对照组比较,差异无统计学意义（P ＞0.05）;观察组手术时间、术中出血量以及住院时间均少于对照组,差异有统计学意义（P ＜0.05）;观察组治疗后裸露阴茎平均长度、疼痛评分均优于对照组,差异有统计学意义（P ＜0 . 0 5）;观察组并发症发生率为3 . 3 3 %,低于对照组的2 3 . 3 3 %,差异有统计学意义（P ＜0 . 0 5）。结论 对儿童隐匿阴茎患儿实施包皮系带延长阴茎整形术的治疗效果确切,可减少手术时间、术中出血量以及住院时间,减轻患儿疼痛,延长裸露阴茎长度,临床应用价值较高。