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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."

[1] Evangelos S, Charalambos C, Dimitrios B , et al. Augmentation phalloplasty surgery for penile dysmorphophobia in young adults: considerations regarding patient selection, outcome evaluation and techniques applied[J]. Eur Urol, 2005,48(1):121-128.
[2] 麦凯欣, 朱辉 . 阴茎增粗术的研究进展[J]. 中国美容整形外科杂志, 2009,20(9):558-561.
[3] Whitehead E. Allograft dermal matrix graft (Alloderm ®) for pericavernosal penile widening in normal men [C]. Abstract pre-sented at: First World Congress on Aesthetic Medicine, 2004.
[4] 杨文博, 张晓威, 兰轲 . 脱细胞异体真皮补片联合阴茎增粗术对早泄的作用与安全性[J]. 中国性科学, 2018,27(7):18-20.
[5] Zhang X, Wu Y, Zhang M , et al. Acellular dermal matrix in premature ejaculation: A preliminary study[J]. Medicine, 2018,97(45):e13135.
[6] Livesey SA, Herndon DN, Hollyoak MA , et al. Transplanted acellular allograft dermal matrix. Potential as a template for the reconstruction of viable dermis[J]. Transplantation, 1995,60(1):1-9.
[7] Chen RN, Ho HO, Tsai YT , et al. Process development of an acellular dermal matrix (ADM) for biomedical applications[J]. Biomaterials, 2004,25(13):2679-2686.
[8] 陈一宁, 但卫华, 但年华 . 脱细胞真皮基质的改性及应用概述[J]. 材料导报, 2018,32(13):2311-2319.
[9] 林健, 郝金瑞, 金杰 , 等. 人同种异体真皮脱细胞基质在尿道重建中的临床应用[J]. 中华医学杂志, 2005,85(15):1057-1059.
[10] 符津山, 周治彦, 许思怡 . 骨髓间充质干细胞联合脱细胞真皮基质修复尿道损伤[J]. 中国组织工程研究, 2018,22(13):2075-2080.
[11] 殷鹏程, 黄万顺, 姚明文 , 等. 4种阴茎增粗术治疗阴茎细小158例疗效分析[J]. 浙江医学, 2016,38(23):1948-1949.
[12] 吴小蔚, 简麒超, 董玉林 , 等. 阴茎延长同期行脱细胞异体真皮基质补片双平面植入阴茎增粗术[J]. 中华医学美学美容杂志, 2011,17(5):336-339.
[13] Tealab AA, Maarouf AM, Habous M , et al. The use of an acellular collagen matrix in penile augmentation: A pilot study in Saudi Arabia[J]. Arab Journal of Urology, 2013,11(2):169-173.
[14] Jung GW . Penile girth enhancement with allograft, penile augmentation[M]. Germany: Springer, 2016: 83-92.
[15] Alter G, Jordan G . Penile elongation and girth enhancement[J]. AUA Update Series, 2007,26:229-237.
[16] Bruno JJ 2 nd , Senderoff DM, Fracchia JA , et al. Reconstruction of penile wounds following complications of AlloDerm-based augmentation phalloplasty[J]. Plast Reconstr Surg, 2007,119(1):1e-4e.
[17] 李战松 . 脱细胞异体真皮基质医用组织补片在阴茎增粗成形中的应用[J]. 中国性科学, 2013,22(10):59-61.
[18] Chu CH, Shieh SJ . Reconstruction of circumferential skin defect of the penile shaft using a bipedicle scrotal flap[J]. Dermatol Surg, 2012,38(2):266-270.
[19] 陶谏, 任永安, 柏龙文 . 阴囊双蒂袋状皮瓣套入法一期修复阴茎皮肤缺损一例[J]. 中华整形外科杂志, 2001,17(3):143.
[20] 王祥, 刘德贵, 石敏 , 等. 阴囊双蒂皮瓣修复包皮环切术后包皮过短[J]. 中华泌尿外科杂志, 1994(6):448.
[21] 陈媛媛, 陆鑫锋, 赵亮 , 等. 阴囊双蒂皮瓣联合皮片移植治疗男性外阴大面积乳房外Paget病[J]. 中华皮肤科杂志, 2012,45(12):904-905.
[22] Weber DM, Landolt MA, Gobet R , et al. The penile perception score: an instrument enabling evaluation by surgeons and patient self-assessment after hypospadias repair[J]. J Urol, 2013,189(1):189-193.
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