Penile Enhancement Using Biodegradable Scaffolds Covered with Platelet-rich Plasma-Fibrin Glue, Mesenchymal Stem Cells for Micropenis
Urology Journal,
Vol. 21 No. 02 (2024),
24 Farvardin 2024
,
Page 126-132
https://doi.org/10.22037/uj.v20i.7915
Abstract
Purpose: Evaluation of preliminary cosmetic and functional outcomes of biodegradable scaffolds covered with
platelet-rich plasma in penile girth augmentation.
Materials and Methods: Between June 2016 and June 2018, 36 males who had a mean age of 28.91 years (range
20 - 48 years) with micropenis underwent this procedure. A mixture of platelets-fibrin glue and mesenchymal cells
obtained from dermal fat tissue were prepared. Then the mixture was seeded on the pretreated tube-shaped poly
lactic-co-glycolic acid scaffold and underwent a whole day of incubation. Following penile degloving, scaffolds
were surgically implanted within the interface region of dartos and Buck's fascia. The 5-point Likert scoring scale
was used to evaluate the patients’ satisfaction with surgery.
Results: Patients followed up for 6-12 (8 ± 2.86) months. The penile length in an erected state before surgery was
6.5 - 12.5 cm (9.08 ± 1.6) which enhanced to 7 - 14 cm (10.59 ± 1.71) after surgery (P < .0001). The penile girth
before and after surgery were 8.49 ± 1.53 and 10.91 ± 1.96 cm, respectively (P < .0001). An augment in penile
length and girth of 1.5 and 2.6 cm were achieved, respectively. Patients appraised surgical intervention on a rating
of one to five. The highest possible score (5) was assigned by 27 %, 33 % expressed a very good mark (4), and 19
% gave a good mark (3).
Conclusion: Covering the scaffold with a mixture of Platelets-Fibrin glue and mesenchymal cells seems a safe and
feasible method for penile reconstruction surgery. More studies should be done to determine the effect of platelets-
fibrin glue and mesenchymal cells for treating micropenis.
- Small penis syndrome
- Girth enhancement
- Tissue engineering
- platelet-rich plasma-fibrin glue
- Patients’ satisfaction
How to Cite
References
Williams RH, Larsen PR. Williams textbook of endocrinology. 11th ed. Philadelphia: Saunders 2008; pp: 842-77.
Wang CH, Lin WD, Bau DT, et al. Penile length of normal boys in Taiwan. Acta Paediatr Taiwan 2006; 47:293-6.
Acerini CL, Hughes IA. Endocrine disrupting chemicals: a new and emerging public health problem? Arch Dis Child 2006; 91:633-41.
Schonbucher V, Schweizer K, Richter-Appelt H. Sexual quality of life of individuals with disorders of sex development and a 46, XY karyotype: A review of international research. J Sex Marital Ther 2010; 36:193–215.
Schober JM. Sexual quality of life in an intersexual population: A needs assessment. BJU Int 2004; 93(suppl 3):54–6.
Perovic SV, Byun JS, Scheplev P, Djordjevic ML, Kim JH, et al. New perspectives of penile enhancement surgery: tissue engineering with biodegradable scaffolds. Eur Urol. 2006 Jan 1; 49:139-47.
Hatipoğlu N, Kurtoğlu S. Micropenis: etiology, diagnosis and treatment approaches. J Clin Res Pediatr Endocrinol. 2013 Dec; 5:217.
Scarcia M, Maselli FP, Cardo G, Ludovico GM .The use of autologous platelet rich plasma gel in bulbar and penile mucosa urethroplasty: Preliminary report of our first series. Arch Ital Urol Androl 2016; 88: 274-8.
ZHOU Z, WU X, SONG H. Platelet rich plasma combined with autologous fat free grafting in penile enlargement surgery. Chinese Journal of Medical Aesthetics and Cosmetology. 2020:342-4.
Kakudo N, Minakata T, Mitsui T, et al. Proliferation-promoting effect of platelet-rich plasma on human adipose-derived stem cells and human dermal fibroblasts. Plast Reconstr Surg. 2008; 122:1352-1360. doi:10.1097/PRS.0b013e3181882046
Shirvan MK, Alamdari DH, Ghoreifi A. A novel method for iatrogenic vesicovaginal fistula treatment: autologous platelet rich plasma injection and platelet rich fibrin glue interposition. J Urol. 2013 Jun 1; 189:2125-9.
Spotnitz WD: Commercial fibrin sealants in surgical care. Am J Surg 2001; 182: 8S.
Seyhan N, Alhan D, Ural AU, et al. The effect of combined use of platelet-rich plasma and adipose-derived stem cells on fat graft survival. Ann Plast Surg. 2015; 74:615-20.
Warmbrod JR. Reporting and Interpreting Scores Derived from Likert-type Scales. J Agric Educ. 2014; 55, 30-47.
De Eguileor M, Tettamanti G, Grimaldi A, et al. Histopathological changes after induced injury in leeches. J Invertebr Pathol 1999; 74: 14–28.
Tettamanti G, Grimaldi A, Rinaldi L, et al. The multifunctional role of fibroblasts during wound healing in Hirudo medicinalis (Annelida, Hirudinea). Biol Cell 2004; 96: 443–55.
Foster TE, Puskas BL, Mandelbaum BR, et al: Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med 2009; 37:2259.
Spotnitz WD: Commercial fibrin sealants in surgical care. Am J Surg 2001; 182: 8S.
Gorodetsky R, Vexler A, An J, Mou X, Marx G: Haptotactic and growth stimulatory effects of fibrin (ogen) and thrombin on cultured fibroblasts. J Lab Clin Med1998; 131: 269
JL Drury, DJ Mooney. Hydrogels for tissue engineering: scaffold design variables and applications: biomaterilas 2003; 24: 4337-51.
Subia B, Kundu J, Kundu SC. Biomaterial scaffold fabrication techniques for potential tissue engineering applications. Tissue Eng. 2010 Mar 1; 141:13-8.
Jin Z, Wu YG, Yuan YM, et al. Tissue engineering penoplasty with biodegradable scaffold Maxpol-T cografted autologous fibroblasts for small penis syndrome. J Androl 2011; 32:491–5.
Santucci RA, Barber TD. Resorbable extracellular matrix grafts in urologic reconstruction. Int Braz J Urol 2005; 31: 192–203.
Li X, Tao L, Cao C, et al. A new surgical method for penile girth enhancement. Int J Clin Exp Med 2015; 8: 10753–9.
Casavantes L, Lemperle G, Morales P. Penile girth enhancement with polymethylmethacrylate-based soft tissue fillers. J Sex Med. 2016; 13:1414–22
Elist JJ, Valenzuela R, Hillelsohn J, Feng T, Hosseini A. A single-surgeon retrospective and preliminary evaluation of the safety and effectiveness of the penuma silicone sleeve implant for elective cosmetic correction of the flaccid penis. J Sex Med. 2018; 15:1216–23
Djordjevic ML, Bumbasirevic U, Stojanovic B, et al. Repeated penile girth enhancement with biodegradable scaffolds: Microscopic ultrastructural analysis and surgical benefits. Asian J Androl. 2018 Sep; 20:488.
Khodamoradi K, Dullea A, Golan R, et al. Platelet Rich Plasma (PRP) Growth Factor Concentration Varies in Men With Erectile Dysfunction. J Sex Med. 2022; 19:1488-93. doi:10.1016/j.jsxm.2022.06.003
- Abstract Viewed: 268 times
- 7915/pdf Downloaded: 224 times