The Preliminary Study Of Sexually Sensitive Unit (SSU) And Clinical Application And Modified Surgical Technique On Repair Of Huge Urethrocutaneous Fistula

Part ?:The preliminary study of Sexually Sensitive Unit(SSU)and clinical applicationThe experimental research on innervation of different tissues of normal male and female perineal regionObjectives.This research was aimed to provide clinical evidence about 'Sexually Sensitive Unit,(SSU)' on genital reconstruction by investigate the innervation of normal male and female perineal region,including male prepuce,female clitoris prepuce,hymen,labia minora and vaginal mucosa.Methods.The samples of human perineal region were well marked,embedded in paraffin,serially sectioned and stained with S100 antibody for nerve fibers.Three slices were chosen randomly from every biopsy for measuring.Three images were randomly selected in each slice and observed under 20 × 10 optical microscope.There were 90 fields of view to be counted in every specimen.Image-Pro Plus 6.0 image analysis software was used to identify and quantify the nerve fibers by using density mean and IOD.These two results represented the average amount and the total amount of the positive expression of the nerve fibers in every slice respectively.Results.1.Tissues sampled from human perineal region,including male prepuce,clitoral prepuce,labia minora,hymen and vaginal mucosa,were highly innervated.2.No significant differences were found among the innervation of male prepuce,clitoral prepuce and labia minora.3.No significant differences were found between the innervation of hymen and vaginal mucosal.4.There was more innervation in male prepuce,clitoral prepuce and labia minora than the hymen and vaginal mucosa.Conclusions.Male prepuce,clitoral prepuce and labia minora were highly innervated.These regions could be transferred with pedicle as SSU in organ reconstructive surgery in order to improve the sexual sensation.The clinic research of Sexually Sensitive Unit(SSU)treatment for sexual function reconstructionObjectives.This research was aimed to investigate the effect of the application of useless/spare"sexually sensitive unit(SSU)" in genital reconstruction.Methods.Fight patients with congenital microphallus and twelve patients with Female Sexual Dysfunction(FSD)owing to vaginal relaxation were underwent genital reconstruction or plasty.During the procedure,high-sensitive receptors of sexual stimulus,such as dysplastic penis,prepuce and labia minora,were transferred to the less sensitive areas,such as peripheral region close to reconstructed penis and lateral wall of vagina.SSU was used as composite tissue for sexual reflex stimulating.Results.The followed up time of 20 cases ranging from 6 to 38 months.All the SSU survived without any complications postoperatively.All patients were satisfied with the appearance and the sexual function.Conclusions.By transferring the SSU to a less sensitive area could bring a good sexual sensation to the patient as well as an ideal appearance.Our modality is a simple,safe and reliable way,which could be one of the option for improving patient's sexual function.Part ?:Modified scrotal-septal flap in repair of huge urethrocutaneous fistula at the penoscrotal junctionObjectives.This research was aimed to investigate the primary repair of huge urethrocutaneous fistula(UCF)at the penoscrotal junction by using a modified scrotal-septal flap.Methods.From January 2011 to July 2012,thirty patients with huge UCF(1cm to 2cm in size)at the penoscrotal junction were underwent surgical repair with modified scrotal-septal flaps.The flap was divided into three zones.Zone A was flipped over to rebuild the urethra;zone B was de-epithelialized and folded to form a waterproof layer by covering the incision of zone A;and zone C was advanced to cover the wound.Results.The followed up time ranging from 6 to 12 months.Urination was smooth in every patient,and no urethrostenosis or fistula was observed.29 flaps survived completely.Venous congestion of the zone C occurred in one case postoperatively,the flap was swollen and eventually lost of dry necrosis.This patient was hospitalized for 15 days and finally discharged with normal urination and no urethrostenosis.Three months follow up showed scarring of the scrotal skin flap,but the patient could void well.Besides,two patients were unsatisfied with their appearances.Conclusions.Using an overturning-folding-advancement scrotal-septal flap could build a urethra,a waterproof layer and a coverage at the same time for the primary repair of UCF at the penoscrotal junction.The technique shown in this study was simple and highly effective,with a minor donor site morbidity,it could achieve satisfactory results.