Penile Reconstruction

　　In childhood, the penis may be bitten off by animals such as dogs and rats, and adult males may suffer from partial or complete penile defects due to injuries such as gunshot wounds, cutting wounds, explosion injuries, and avulsion injuries. The penis is the root of men and an important link in maintaining marriage and family. Therefore, penile defects can cause great physical and psychological pain to patients and should be reconstructed to restore normal urination and reproductive function.

　　Penile reconstruction surgery is a relatively complex surgery, and if there are problems with the surgery, possible complications may include balanopreputial hematoma, urethral fistula, and others.

　　1, Hematoma

　　It is caused by various external forces, leading to vascular rupture, blood separation from surrounding tissues, and forming a cavity filled with blood.

　　2, Urethral fistula

　　It refers to the abnormal channel formed between the reproductive organs and the urinary system, manifested as urinary incontinence. Common ones include vesicovaginal fistula, urethrovaginal fistula, and ureterovaginal fistula (collectively known as fistula).

　　Penile reconstruction is a relatively complex plastic surgery. There are many methods, such as the skin tube method, which generally forms a one-yard-long skin tube in the abdomen or thigh and requires four surgical transfers. So, under what circumstances is it necessary to perform penile reconstruction surgery?

　　According to the vaginal anatomy and female physiological characteristics, as well as the normal length measurement of adult male penile length in China, the normal length is 7.1±1.5 cm in a relaxed state, and 13.0±1.3 cm when erect. If the penis does not develop well, the length during erection is less than 10 cm, and it does not meet the sexual requirements of the female, penile lengthening surgery can be performed.

　　For most of the penis defect, the length during erection is generally only 3-5 cm. In the past, routine penile reconstruction surgery was performed, but the reconstructed penis currently has no normal erection and sensation function. Penile corpus cavernosum extension surgery, cutting the superficial and deep ligaments to the pubic arch, makes the cavernous body buried in front of the pubic symphysis become a free part, thereby increasing the effective length of the penis. The abdominal inguinal island flap is used to repair the skin injury surface after the cavernous body is extended. This surgical method not only makes the penis extend to a length close to normal but also has normal erection and sensation function.

　　For small penis, when erect, the length and circumference are between 5-8 cm, and when the testicle volume is greater than 6 ml, simultaneous penile augmentation and lengthening surgery should be performed to make the penile shape closer to normal.

　　For congenital penile ectopic deformity, penile lengthening surgery should be adopted according to the condition to lengthen and realign the penis.

　　For penile venous fistula impotence, simultaneous penile lengthening surgery can be performed while ligation of the deep and superficial penile veins, often achieving more satisfactory results than before.

　　The causes of congenital penile deformity are very complex, including infections during pregnancy, advanced age of childbearing, consanguineous marriage, radiation, chemicals, autoimmune diseases, and abnormal genetic material, etc. Therefore, it is necessary to pay attention to the following preventive measures:

　　1. Prohibit close kinship marriage.

　　2. Pre-marital examination to detect genetic diseases or other diseases that should not be married.

　　3. Detection of carriers Through means such as mass surveys, family investigations, pedigree analysis, and laboratory tests, determine whether it is a genetic disease and determine the mode of inheritance, etc.

　　4. Genetic counseling.

　　5. Prenatal diagnosis Prenatal diagnosis or intrauterine diagnosis is an important measure of preventive eugenics.

　　During the first visit, the doctor will examine you to understand your畸形 condition and the cause of the penile deformity, and you should honestly present your medical history; at the same time as the physical examination, comprehensive auxiliary examinations are needed.

　　1. Understand the development of internal reproductive organs.

　　2. Whether there is androgenism, which is crucial for the selection of surgical methods.

　　3. Before surgery, stop smoking and drinking alcohol; discontinue medications such as aspirin that can increase bleeding; clean the perineum every night the day before surgery.

　　4. Routine bowel preparation before surgery.

　　5. Clean enema the night before surgery.

　　After the penile reconstruction surgery, it is recommended that patients should pay attention to the following dietary principles:

　　1. You can eat some foods that promote wound healing, such as pork feet, milk, honey, bitter melon, tomatoes, kelp, oranges, etc.

　　2. You can drink some tea made with lotus seed core. In traditional Chinese medicine, fruits that grow in water are generally more yin, which can calm the mind, clear inflammation, and also reduce sexual excitement. It can temporarily reduce desire.

　　3. Do not eat spicy and刺激性 things, pay attention to hygiene, and avoid wound inflammation.

　　4. Fermented bean curd, scallions, chili peppers, chives, etc., are prone to infection and are not conducive to wound healing.

　　The rational and timely use of medication and regular follow-up observation are very important. Some patients have efficacy with chorionic gonadotropin. Surgical treatment is suitable for patients with confirmed male, using penile elongation plastic surgery, the purpose of which is to make the penis achieve the maximum length. If the penis develops extremely poorly, it can change the gender to female early. If the patient and family members request to be identified as male, penile reconstruction surgery can also be performed, but the surgical effect is often not satisfactory.