Insertion of erectile device following phalloplasty in individuals assigned male at birth: a systematic review.

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine Pub Date : 2025-07-14 DOI:10.1093/jsxmed/qdaf019

Karl H Pang, Nim Christopher, David J Ralph, Wai Gin Lee

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引用次数: 0

Abstract

Introduction: Erectile devices can be used to achieve erectile rigidity after phalloplasty in assigned male at birth (AMAB) individuals for congenital or acquired penile inadequacy. The insertion technique in a neophallus is different and more challenging compared to that of an anatomical penis.

Objective: To perform a systematic review, summarizing the literature on the insertion of erectile devices in the neophallus of individuals AMAB focusing on techniques, types of devices used, postoperative complications and patient reported outcomes.

Method: The review was performed according to the PRISMA statement. A search of the PubMed database was performed on June 17, 2023 (updated on September 11, 2024) retrieving 86 articles. Overall, 15 studies fulfilled the inclusion criteria and were included in the analysis.

Results: 184 AMAB individuals had an erectile device inserted. The indications for phalloplasty were penile inadequacy secondary to bladder exstrophy-epispadias complex (46.5%), penile cancer (18.6%), trauma (16.7%), disorder of sex differentiation or micropenis/hypospadias (14.7%), male-female reversal (2.7%), and infection (0.8%). A radial artery forearm free flap was used in 91.1% of patients. The AMS 700 inflatable prosthesis was the most common device inserted. Most studies used a graft to cover the distal cylinder tips to reduce the risk of erosion. Up to 64.3% of patients experienced a complication. Infection, mechanical failure/dysfunction, and malposition/migration/under-sizing occurred in up to 33.3%, 28.6% and 40%, respectively. Explantation was required in up to 40% of patients for erosion. Up to 33.3% of patients had their erectile device revised or replaced. Overall, 80%-100% were satisfied with the outcomes.

Conclusion: Erectile device insertion in AMAB individuals following phalloplasty for penile inadequacy is an acceptable and satisfying option to achieve rigidity for sexual intercourse. However, this is a challenging procedure associated with significant risks of complication.

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阴茎成形术后插入勃起装置的个体在出生时被指定为男性：一个系统的回顾。

勃起装置可用于先天性或获得性阴茎不足的先天性男性（AMAB）个体在阴茎成形术后实现勃起刚性。与解剖上的阴茎相比，新阴茎的插入技术是不同的，更具挑战性。目的：对AMAB患者阴茎内插入勃起装置的相关文献进行系统综述，重点关注技术、使用的装置类型、术后并发症和患者报告的结果。方法：按照PRISMA标准进行复查。在2023年6月17日对PubMed数据库进行了检索（更新于2024年9月11日），检索了86篇文章。总共有15项研究符合纳入标准并被纳入分析。结果：184名AMAB个体植入了勃起装置。阴茎成形术的适应症为膀胱外翻-尿道外裂复合症所致的阴茎功能不全（46.5%）、阴茎癌（18.6%）、外伤（16.7%）、性别分化障碍或小阴茎/尿道下裂（14.7%）、两性逆转（2.7%）和感染（0.8%）。91.1%的患者采用前臂桡动脉游离皮瓣。AMS 700充气假体是最常见的植入设备。大多数研究使用移植物覆盖远端椎体尖端，以减少侵蚀的风险。高达64.3%的患者出现了并发症。感染、机械故障/功能障碍、体位错位/移位/尺寸不足的发生率分别高达33.3%、28.6%和40%。高达40%的糜烂患者需要进行手术。高达33.3%的患者修改或更换了勃起装置。总体而言，80%-100%的患者对治疗结果满意。结论：AMAB患者在阴茎成形术后插入勃起装置是一种可接受和令人满意的选择，以实现性交的刚性。然而，这是一项具有挑战性的手术，并发症的风险很大。

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 Sexual Medicine 医学-泌尿学与肾脏学

CiteScore

6.20

自引率

5.70%

发文量

826

审稿时长

2-4 weeks

期刊介绍： The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.