Experimental and clinical study on functional restoration of the penis with large partial defect / 北京大学学报(医学版)

ABSTRACT

Objective:To investigate the effective restoration method in penile partial defect.Meth-odsTo measure the thickness of suspensory ligaments on cadavers;To find the relationship between in-ferior pubic ramus and corpora cavernosa crus through corpora cavernosa angiography and ultrasonic scan-ning.The procedure of restoration was based on the use of dissection of the suspensory ligaments and partof crus,and the local fat flap had been transferred to fill the front space of symphysis ossium pubi.Vari-ous flaps were designed as coverage material.Penis residual stump was advanced to anterior portion of thenewly restoration penile body as“glans”;To take full layer skin of penis from post-operating patients toobserve neurofibril regeneration by light microscopy,electron microscopy and scanning electron microsco-py;To determine sensation recovery by physical examination;To check erectile function with NEVA Sys-tem.Results:The whole suspensory ligaments thickness was 7.66cm in average on 30 cadavers(60sides).The crus were attached to bilateral inferior pubic ramus respectively,and distal reached the mid-dle of inferior pubic ramus by corpora cavernosa angiography.In 14 health men by ultrasonic scan-ning,6.60cm in average from root of external penis to location of deep artery penis entered corpora cavernosa.Forty patients had been operated with the above methods.In the cases,the length of the penis variedfrom 0.5-4.0cm in the flaccid,2.0-6.0cm in erect state before operation to 5.0-8.5 cm in theflaccid,7.0-12.5cm in erect state after operation.Twenty-eight cases had been followed up for morethan one year,and 23 patients married with acceptable sexual life,eighteen men had successfully pro-duced their next generations.The regenerative neurofibril could be seen under light microscope,immuno-histochemistry marker,scanning and transmission electron microscope.The penis presented normal painand touch feeling in the post-operating cases.The results showed that there was similar erectile ability ofa normal male in the follow-up patients.Conclusion:With these basic and clinical researches,the resto-ration of penis tends to have a better appearance and function.It's a more optimal method compared withconventional procedures.The results have also provided valuable data for further study in related fields.