하복부 지방과 유경피판으로 외음부 동맥을 이용한 음경확대술의 경험 = Penile Augmentation Using Superficial External Pudendal Artery Pedicle and Adipose Tissue

다국어 초록 (Multilingual Abstract)

Purpose: Many men are to some degree unsatisfied with the size of their penis, whether it is normal in size and appearance or not. We report a novel surgical technique for penile augmentation using a superficial external pudendal artery pedicle.
Materials and Methods: In total, 8 patients underwent penile augmentation from March 2003 to February 2004. Their mean age was 37.3 years. Five patients were unsatisfied about the size of their penis, and three patients had complications after insertion of foreign material. This penile augmentation technique was developed by using a low abdominal fat-flap where blood is supplied from the external pudendal artery. Spinal or epidural anesthesia was done during the operation, and the fat-flap was elevated and transpositioned to the site of lesion.
Results: All cases of patients were performed successfully by autografting using adipose tissue where blood flow was supplied from the external pudendal artery. There were no complications except one case of hematoma after the operation. The mean operative time was 80 min. The mean follow-up period after operation was about 6 months and all patients had a normal sexual life and no voiding dysfunctions.
Conclusions: This novel surgical technique has several advantages. First, reconstruction without skin necrosis was possible even though the defect was large, because the blood supply was favorable. Second, there was no size limitation in augmentation with dermoplasty. Third, there was no evidence of atrophy of the flap.

참고문헌 (Reference)

1 Maliniac JW, "Use of pedicle dermofat flap mammoplasty" 12 : 110-115, 1953

2 Park NC, "Troublesome fate of the penile augmentation with artificial oil analogues" 9 : 49-53, 1991

3 Peer LA, "Transplantation of fat" 1 : 109-111, 1967

4 Dias AD, "The superficial external pudendal artery (SEPA) axial-pattern flap" 37 : 256-261, 1984

5 Patil UA, "The anatomical basis of the SEPA flap" 40 : 342-347, 1987

6 Barton JL, "Textbook of Dermatology" Blackwell 1870-1871, 1986

7 Park NC, "Surgical advances in penile augmentation" 21 : 115-124, 2003

8 Elson ML, "Soft tissue augmentation in A review" 21 : 491-500, 1995

9 Pollack SV, "Silicone, fibrel, and collagen implantation for facial lines and wrinkles" 16 : 957-961, 1990

10 Chiu DTW, "Repair and grafting of dermis, fat and fascia in Plastic surgery" W. B. Saunders 508-526, 1990

11 Comper WD, "Physiological function of connective tissue polysaccharides" 58 : 255-315, 1978

12 Alter GJ, "Penis enhancement" 15 : 93-100, 1996

13 Lee HS, "Penile skin necrosis after dermal fat graft augmentation" 15 : 77-9, 1997

14 Alter GJ, "Penile enlargement surgery" 4 : 70-76, 1998

15 Knapp TR, "Injectable collagen for soft tissue augmentation" 60 : 398-405, 1977

16 Moon DG, "Effects of injectable hyaluronic acid gel in augmentation of glans penis" 21 : 38-43, 2003

17 Park IC, "Cutaneous fistula in patient in augmentation penoplasty" 20 : 57-58, 2002

18 Wessells H, "Complications of penile lengthening and augmentation seen at 1 referral center" 155 : 1617-1620, 1996

19 Trockman BA, "Complication of penile injection of autologous fat" 151 : 429-430, 1994

20 Alter GJ, "Augmentation phalloplasty" 22 : 887-902, 1995

21 Bames HO, "Augmentation mammoplasty by lipo- transplant" 11 : 404-414, 1953