新型中空硅橡胶睾丸假体移植术治疗睾丸缺失的临床体会(附13例报告)

摘要

目的 评价新型中空硅橡胶睾丸假体阴囊移植术治疗男性睾丸缺失临床应用的安全性和有效性.方法 2009年1月至2011年3月,临床选择13例睾丸缺失者行睾丸假体植入术,包括:前列腺癌睾丸去势术2例、睾丸癌根治术5例、1侧无睾症2例、双侧无睾症1例、睾丸扭转坏死1例、睾丸萎缩1例、女性假两性畸形1例.睾丸假体为国产中空硅橡胶假体,13例中有4例在睾丸切除同时进行假体植入,另9例植入时间在睾丸切除6个月后;假体均为硅橡胶材料,睾丸假体的大小根据患者阴囊可容纳的空间及对侧睾丸大小来选择.结果 13例术后无感染、出血等并发症发生.手术6个月后进行随访;所有病例对植入睾丸假体后的阴囊外观及大小感到非常满意;对植入假体的重量:7例感到非常满意,5例感到较满意.全组无假体破裂及排异反应病例.结论 新型中空硅橡胶睾丸假体阴囊移植术治疗男性睾丸缺失能满足患者外观及心理的需要,临床表明安全有效.但长期生活质量及并发症还需进一步观察,设计更舒适及有功能的缓释型睾丸假体还需进一步研究.%Objective To investigate the effects and safety of the new-typed testicular prosthesis in the treatment of patients with absence of testis. Methods From Jan. 2009 to Mar. 2011, 13 patients (including 2 cases of prostate cancer, 5 cases of testicular cancer, 2 cases of unilateral anorchia, 1 case of bilateral anorchia, 1 case of testicular torsion, 1 case of orchiatrophy and 1 case of hermaphroditism) who had undergone testicular prosthesis implantation were recruited in this study. Four of the 13 cases immediately received testicular prosthesis implantation after orchiectomy, and other 9 cases received testicular prosthesis implantation 6 months later. The prosthesis was selected according to the conditions and volume of scrotum. Results Following-ups in the six months didn't show any complications. All the patients were satisfied with their scrotal appearance. About the weight of the testis seven patients were very much satisfied and five were satisfied. No rupture of prosthesis or rejection were reported. Conclusion The new-typed hollow silicone elastomer testicular prosthesis used in this study can meet patients ' requirements. Testicular prosthesis implantation should be a promising approach for patients undergoing orchidectomy. But further surveillance and long-term life quality follow-ups should be investigated.