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RADIAL FOREARM FLAP
前臂培養陰莖蓋皮術
涂懿美
譯
前臂培養陰莖蓋皮手術是一個很繁複的手續。主要是用前臂上的皮膚、動脈血管和神經來製造陰莖，然後以顯微技術把做好的新陰莖黏接到恥骨上；陰核的神經接合陰莖皮膚上的神經，而尿道則被引導到陰莖口，以便患者能直立小便。本手術主要的好處在於：陰莖的外觀很棒，可以直立小便，而且陰莖通常能夠有感覺，手術大約一年後便可以內植勃起裝置，以便進行陰道性交。從另一方面來說，這個手術工程浩大，而且有很大的風險，包括有百分之五的機率可能喪失全部的包皮、或者漏尿、或者縮狹化。前臂上的結痂也是個大問題，看起來像是燒傷的結痂，這也是大多數患者駐足不做這個手術的主要因素。不過，除了前臂上的結痂之外，本手術的最後結果無論從美學或使用的觀點來看都可能是最好的選擇。由於這是一個很複雜的手術，風險實在很高，而可能的併發狀況也可能帶來長期的影響，最好是在那些大型的醫學中心由擁有豐富經驗的外科手術小組完成。
The radial forearm flap is
an extensive procedure, which uses the skin, arteries and nerves of the
forearm to make the penis. The new penis is then attached to the pubis by
microsurgical techniques. The nerves of the clitoris are attached to the
nerves of the skin of the penis. The urethra is brought out to the tip of
the penis to allow the patient to stand to urinate. The principal
advantages of this operation are that the appearance the penis is very
good, one can stand to urinate, and the penis will usually develop
sensation. One year later an erection device can be placed to allow for
vaginal intercourse. On the other hand, this is a formidable operation
with significant risk, including complete loss of the flap (approximately
5%), urinary leaks, and stricture. The scar
on the arm can also be quite formidable, resembling a burn scar of the
arm, and in many patients the major deterrent to this operation.
Nevertheless, excepting the donor scar on the arm, the final result is
probably the best from the aesthetic and functional standpoint of all the
operations available. This is an operation that is a major undertaking and
should be done at a center with a team of surgeons that routinely does
them. The risks are profound and the complications can have long term
implications.
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