title: Tissue engineering penoplasty with biodegradable scaffold Maxpol-T cografted autologous fibroblasts for small penis syndrome.
abstract: In this study, we investigated the safety and efficacy of a poly acid-co-glycolide biodegradable scaffold (Maxpol-T) coated by autologous fibroblasts (AF) for penile girth enlargement in small penis syndrome (SPS). Eighty patients with SPS were enrolled in a clinical study at 2 medical centers; 69 patients completed the study protocol. Scrotal skin was harvested under local anesthesia, and AFs were cultured and seeded on a Maxpol-T scaffold; the cografted scaffold was implanted under the Buck's fascia of penile shaft via a circumcising incision. Patients were followed up at 1, 3, and 6 months to evaluate penile girth changes. Patient satisfaction was assessed via Visual Analogue Scale and scored on the International Index of Erectile Function-5 (IIEF-5). Mean preoperative penile girth in the flaccid and erect state was 8.18 ± 0.83 cm and 10.26 ± 1.22 cm, respectively. At the 6-month postoperative follow-up, mean penile girth in the flaccid and erect state was increased to 12.19 ± 1.27 cm and 13.18 ± 1.31 cm, respectively (P < .001 for change in both flaccid and erect state). Sixty-five patients (94.2%) reported satisfaction with the procedure. Among them, 4 cases (5.8%) were dissatisfied, 7 cases (10.1%) were satisfied, 26 cases (37.7%) were very satisfied, and 32 cases (46.4%) were extremely satisfied. All men maintained IIEF-5 scores of more than 22. Complications included prolonged subcutaneous edema in 3 patients (4.3%) and pinpoint erosion at the suture area in 3 patients (4.3%). Implantation of autologous fibroblasts seeded on a Maxpol-T collagen scaffold holds promise as a safe and novel technique for penile girth enhancement in patients with SPS.
authors.affiliation: Andrology Center, Peking University First Hospital, Peking University, Beijing (100009), China. xinzc08@gmail.com
authors.forename: Zhe
authors.initials: Z
authors.lastname: Jin
authors.forename: Yi-Guang
authors.initials: YG
authors.lastname: Wu
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Yuan
authors.forename: Jing
authors.initials: J
authors.lastname: Peng
authors.forename: Yan-Qing
authors.initials: YQ
authors.lastname: Gong
authors.forename: Guang-Yong
authors.initials: GY
authors.lastname: Li
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Song
authors.forename: Wan-Shou
authors.initials: WS
authors.lastname: Cui
authors.forename: Xue-You
authors.initials: XY
authors.lastname: He
authors.forename: Zhong-Cheng
authors.initials: ZC
authors.lastname: Xin
mesh_terms: D000328:Adult; D005347:Fibroblasts / Q000637:transplantation*; D006801:Humans; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010413:Penis / Q000601:surgery*; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D013577:Syndrome; D023822:Tissue Engineering / Q000295:instrumentation* / Q000379:methods*; D054457:Tissue Scaffolds; D013521:Urologic Surgical Procedures, Male / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult
chemical_list: D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid