利用腹壁下动脉穿支皮瓣阴茎再造的临床研究

目的 探讨腹壁下动脉穿支(DIEP)皮瓣阴茎再造手术方法的临床疗效.方法 2003年12月至2006年11月收治体外热疗致阴茎严重烧伤2例、假两性畸形1例、动物咬伤致阴茎大部缺损1例.患者平均年龄31岁.术前残余阴茎常态下长度0.5～1.5 cm.应用DIEP皮瓣及第12肋骨植入行一期阴茎再造术.结果 4例手术均成功,皮瓣完全成活,术后未发生感染、尿道狭窄等并发症.3例术后随访5～32个月,再造阴茎外形逼真,阴茎定型长度7.5～11.0 cm,排尿正常,未发生严重感染及尿道狭窄,皮肤感觉与勃起功能良好.1例近期手术者随访3个月阴茎感觉仍在恢复中.结论 该手术方法设计合理,手术一期完成,术后再造阴茎形态功能良好,能满足患者及配偶性生活的要求.供区损伤小,是比较理想的阴茎再造方法.

Penile reconstruction using deep inferior epigastric perforator flap

Objective To explore a new surgical procedure for phallic reconstruction. Methods Since Dec 2003 to Nov 2006,4 patients with penile loss were reconstructed by transferring a deep in-ferior epigastric perforator(DIEP)flap with implanting the 12th costal cartilage. Results All of the flaDs survived successfully.With the follow-up from 5 months to 3 years,the appearance oi the neope-nis and donor-site scar was satisfactory. No one developed fistula or urethral stenosls, All patients were reported the return of erogenous sensibility of the neopenis leading to orgasm and achmving Pene-tration during sexual intercourse. Conclusions This new procedure may provide an esthetlcaIlY ac-ceDtable and functional neophallus.It might be a new alternative in penile reconstruction.