Amputazione parziale del pene per carcinoma squamocellulare con ricostruzione mediante lembo ventrale fenestrato
Le terapie chirurgiche per lesioni neoplastiche del pene debbono obbedire ad una strategia che nel rispetto assoluto della radicalità oncologica,tenga conto delle future esigenze funzionali,minzionali ,sessuali ed estetiche.
L’esame istologico relativo alla biopsia della lesione,ha diagnosticato un carcinoma squamocellulare Stadio T2,N0,M0 per cui si è ritenuto opportuno procedere ad una amputazione parziale del pene.
Incisione cutanea a becco di flauto.
Si seziona la fascia di Buck
Si clampa il fascio nerveo-vascolare-dorsale del pene e lo si cliva ventralmente separandolo dalle strutture albuginee.
Si sutura il moncone prossimale.
lasciando una lunghezza che consenta la massima sensibilità nel rispetto della radicalità oncologica.
Si posiziona un laccio emostatico alla redice del pene.
Si clampa l’uretra con pinze,poi viene isolata e sezionata
amputando il terzo distale.
Si procede quindi alla sezione dei corpi cavernosi e all’amputazione del terzo distale del pene.
Chiusura dei corpi cavernosi.
Si spatula il moncone uretrale ad ore 3 e ad ore 9
Si fenestra il lembo cutaneo che viene suturato al moncone uretrale.
Questa tecnica consente di costruire un buon prepuzio e di ridurre le probabilità di stenosi meatale.
Si posiziona un drenaggio che verrà rimosso nelle prime 24-48 ore.
Il lembo cutaneo fenestrato dopo l’uretrocutaneostomia viene ribattuto dorsalmente e suturato alla guaina peniena.
Il risultato estetico-funzionale è stato buono,il paziente dopo un mese dall’intervento ha ripreso un’attività sessuale giudicata da lui soddisfacente,nonostante la riduzione di lunghezza del pene.
I have a friend who did the same treatment and found enough good.tk.y information, greetings
If possible, I would like to know something more on the residual function after surgery, many thanks
I did not believe that a penile cancer could be solved so easily, on the other hand there has been some reduction so long, but the patient still can always have a certain sexual activities, so you have to make do!
I have a friend who has done such an intervention, actually managed to eradicate the cancer even if its functionality is not really very satisfying, because in particular has significantly reduced the sensitivity and this creates some .They said that in time we It will be a little ‘recovery.
It ‘s really an incredible intervention, I do not know how we can do even sex after an intervention like that, but it seems this person has maintained a satisfactory sexual activity, is a true miracle.
I did not believe possible an intervention of this tipe.Image beautiful.
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very complicated surgery, but fortunately there is, then desperate times, desperate measures
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