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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (4): 636-640. doi: 10.19723/j.issn.1671-167X.2019.04.007

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Complications and management for penile augmentation with acellular dermal matrix

Ting-min XU,Xiao-wei ZHANG,Guo-xi ZHANG,Wen-jun BAI,Qing LI,Tao XU()   

  1. Department of Urology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2019-03-13 Online:2019-08-18 Published:2019-09-03
  • Contact: Tao XU E-mail:xutao@pku.edu.cn
  • Supported by:
    Supported by the National Natural Science Foundation of China(81872086)

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Abstract:

Objective: To investigate and analyze the complications of penile augmentation with acellular dermal matrix (ADM) and following management.Methods: This was a retrospective review of all patients who received penile augmentation with ADM between June 2016 and January 2019. The patients were evaluated with outpatient physical examination. Related complications and following management were summarized and analyzed.Results: Between June 2016 and January 2019, ADM was used as filling material on 78 patients (mean age: 31.14 years, range: 21-66 years), who were successfully received penile augmentation surgery. In the follow-up three months, the penile circumference was increased by 1.1 cm (0.5-2.1 cm) on average. The mean follow-up time was 12.20 months. In this study, there were 47 (60.26%, 47/78) patients with erectile discomfort, 91.49% (43/47) of whom manifested as erectile traction. There were 12 (15.38%, 12/78) patients with delayed healing, improved by daily regular dressing change. There were 10 (12.82%, 10/78) patients with unobvious augmentation effect. There were 9 (11.54%, 9/78) patients with stamp-like changes of ADM. There were 8 (10.26%, 8/78) patients with wound hematoma and 7 (8.97%, 7/78) patients with foreskin edema, relieved by compression with wrap. There were 4 (5.13%, 4/78) patients with wound infection and 3 (3.85%, 3/78) patients with skin necrosis of the dorsal side, which could be treated with ADM removal and repair surgery with bipedicle scrotal flap. And there were 2 (2.56%, 2/78) patients suffering psychological influence. Finally, most patients with various complications recovered successfully, however 7 patients (8.97%, 7/78) underwent ADM removal surgery.Conclusion: Using ADM as filling material could achieve positive effect in penile augmentation but the complications are common and cannot be neglected. Standardized surgical methods, rigorous postoperative care, and adequate notification with patients can effectively reduce the complications of penile augmentation with ADM. To treat properly and timely for complications can obtain satisfactory results.

Key words: Penis, Acellular dermal matrix, Complications

CLC Number: 

  • R697.1

Figure 1

Complications of penile augmentation with ADM A, penile dorsal skin necrosis leading to wound infection and ADM patch exposure, with presence of foreskin edema; B, delayed healing; C-E, stamp-like change and surgery to remove ADM patch; F, skin necrosis on the dorsal side (1 week after surgery); G, skin necrosis on the dorsal side (2 weeks after surgery)."

Figure 2

Delayed healing: 2 months after penile girth enhancement with ADM, improved by regular daily dressing change"

Figure 3

Treatment of penile dorsal skin necrosis: application of bipedicle scrotal flap A-B, before surgery; C, repair surgery with bipedicle scrotal flap; D, 3 days after surgery; E, after pedicle division; F, 4 months after surgery."

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