Functional outcomes after supra-pubic phalloplasty

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2024-09-20 DOI:10.1016/j.bjps.2024.09.065

Romain Pelette , Nicolas Morel-Journel , Damien Carnicelli , Alain Ruffion , Léna Paganelli , Charles-Hervé Vacheron , Manon Terrier , François Xavier Madec , Paul Neuville

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引用次数: 0

Abstract

Background

A thorough evaluation of the functional outcomes resulting from supra-pubic phalloplasty (SPP) assessing different aspects of the phalloplasty technique has not been reported.

Purpose of the study

To report the outcomes on sexuality, urinary function, satisfaction, and regrets following SPP performed at our centre.

Subjects studied

All consecutive patients who underwent the three-step technique of pre-expanded SPP between 2007 and 2018 and who had at least one year of follow-up.

Methods

Questionnaires were sent to analyse several domains of penile reconstruction: sexuality, urinary function, perceived sensitivity, and satisfaction. Sexuality was evaluated using the Self-Esteem And Relationship (SEAR) questionnaire. Urinary function was analysed based on the urethral stricture surgery patient-reported outcome measures (USS-PROM) questionnaire.

Main findings

A total of 77 patients were included, 92.2% were transmen, and 33 (42.9%) responded to the questionnaire. Urethral lengthening (UL) was performed in 28 (36.4%) procedures, and erectile prosthesis was implanted in 42 patients (54.5%). The mean length of the neophallus was 15.3 cm (standard deviation [SD] 2.6), and the mean girth was 11.8 cm (SD 2.1). The mean total SEAR score (/100) was 73.8 (SD 26.7). The mean six-item lower urinary tract symptom score (/24) was 8.4 (SD 4.6). The standing position was the usual voiding position reported by 11 patients (73.3%).

Conclusion

Pre-expanded SPP is a robust technique that can achieve substantial flap dimensions, leading to high satisfaction with neophallus appearance and the choice of the phalloplasty technique. Overall, sexual outcomes are mostly favourable. UL is feasible and effective in terms of voiding in a standing position.

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耻骨上阴茎成形术后的功能效果。

背景：对耻骨上阴茎成形术（SPP）的功能结果进行全面评估，并对阴茎成形术技术的不同方面进行评估的报告尚未见报道：研究目的：报告在本中心进行耻骨上阴茎成形术（SPP）后在性生活、排尿功能、满意度和遗憾方面的结果：2007年至2018年期间接受预扩张SPP三步技术的所有连续患者，且随访至少一年：调查问卷用于分析阴茎重建的几个方面：性生活、排尿功能、感知敏感度和满意度。性能力通过自尊与关系（SEAR）问卷进行评估。泌尿功能根据尿道狭窄手术患者报告结果测量（USS-PROM）问卷进行分析：共纳入 77 名患者，其中 92.2% 为跨性别男性，33 人（42.9%）回答了问卷。28名患者（36.4%）接受了尿道延长术（UL），42名患者（54.5%）植入了勃起假体。新阴茎的平均长度为 15.3 厘米（标准差 [SD] 2.6），平均周长为 11.8 厘米（标准差 2.1）。平均 SEAR 总分（/100）为 73.8（标准差 26.7）。下尿路症状六项平均得分（/24）为 8.4（标清 4.6）。11名患者（73.3%）表示站立位是通常的排尿姿势：结论：预扩张 SPP 是一种稳健的技术，可以获得较大的皮瓣尺寸，从而使患者对新阴茎的外观和阴茎整形技术的选择非常满意。总体而言，性功能结果大多良好。就站立位排尿而言，UL 是可行且有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.