Efficacy evaluation of sural nerve bridging transplantation for restoration of penis disturbance of sensation after selective dorsal nerve neurotomy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SI Si , WANG Huaisheng , PU Yi ,  CEN Ying ,  XIAO Haitao

Department of Burns and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

CEN Ying, Email: Cenying0141@163.com; XIAO Haitao, Email: xhaitao@163.com

Keywords：

Selective dorsal nerve neurotomy; sensation disturbance; nerve bridging transplantation; sural nerve

DOI：

10.7507/1002-1892.201611114

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical effect of sural nerve bridging transplantation for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy. Methods Between May 2014 and May 2016, 23 patients underwent sural nerve bridging transplantation for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy. The age ranged from 19 to 38 years (mean, 27 years). The course of disease was 1-28 months (mean, 14 months). The defect length was 1.0-1.5 cm. Preoperative main neurological sign was sensory disturbance. The chief complaint of 21 patients was a erectile dysfunction; all had normal hormone levels, and there was no other organic diseases or surgical contraindication. According to the self-assessment lists of symptom-SCL90 evaluation, 19 cases had depression, 16 cases had anxiety, and 15 cases had both anxiety and depression; 3 cases had psychological abnormalities (social barriers, etc.). According to the functional neurological evaluation standard of British Medical Research Institute, the static two-point discrimination and sensation recovery standard rating were evaluated before and after operation; sexual pleasure obstacle sensitivity, temperature sense, and other subjective improvement were recorded. The International Index of Erectile Function 5 (IIEF-5) was used to evaluate questionnaire of the patient with erectile dysfunction before and after operation. The psychological state was accessed with the self-assessment lists of symptom-SCL90 evaluation after operation. Results All incisions healed by first intention. The mean follow-up time was 8 months (range, 6-12 months). Sexual pleasure obstacle was obviously improved in 11 cases, partially improved in 5 cases; the improvements in temperature and tactile sensitivity were achieved in 21 cases; no obvious improvement was observed in 1 case. The sensation recovery standard rating, static two-point discrimination and grade of IIEF-5 were significantly improved at 3 and 6 months after operation when compared with preoperative ones (P<0.05). At 6 months after operation, symptom was improved in 14 of 19 patients with depression (73.68%), in 12 of 16 patients with anxiety (75.00%), and in 12 of 15 patients with anxiety and depression(80.00%). Conclusion Sural nerve bridging transplantation is an effective method for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy.

Citation： SI Si, WANG Huaisheng, PU Yi, CEN Ying, XIAO Haitao. Efficacy evaluation of sural nerve bridging transplantation for restoration of penis disturbance of sensation after selective dorsal nerve neurotomy. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(6): 709-713. doi: 10.7507/1002-1892.201611114 Copy

1.	Tullii RE, Ferreira R, Vaccari R. Neurotomy: a new thera-peuticechnique for primary premature ejaculation. Proceeding of the 4thAsia-Pacific Impotencea Meeting, 1993: 134-135.
2.	Lee YS. Effect of dorsal nerve neurotomy in patients with premature ejaculation. Programme&Abstracts of China-Korea Medical Conference’97. 1997: 380.
3.	郭应禄. 阴茎勃起功能障碍. 北京: 北京医科大学出版社, 1999: 58-59.
4.	邓立文, 涂响安, 邓春华, 等. 慢性前列腺炎患者性功能状况与精神症状调查研究. 中国临床实用医学, 2007, 1(9): 5-7.
5.	薛珺, 汪静宇, 陈利生, 等. 早泄的研究进展. 中华男科学杂志, 2007, 13(1): 65-68.
6.	American Psychiatric Association. Diagnostic and statistical manual ofmental disorders. 4th eds. Text Revision. Washington DC: American Psychiatric Association, 2000: 68.
7.	Montague DK, Jarow J, Broderick GA, et al. AUA guideline on thepharmacologic management of premature ejaculation. J Urol, 2004, 172(1): 290-294.
8.	Althof SE, McMahon CG, Waldinger MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med, 2014, 11(6): 1392-1422.
9.	Althof SE, Abdo CH, Dean J, et al. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med, 2010, 7(9): 2947-2969.
10.	孙中义, 李彦锋, 周波, 等. 阴茎背神经选择性切断术提高阴茎感觉阈值的临床分析. 中国男科学杂志, 2010, 24(10): 46-48.
11.	顾玉东. 周围神经缺损的基本概念与治疗原则. 中华手外科杂志, 2002, 18(3): 129-130.
12.	Millesi H. Microsurgery of peripheral nerves. World J Surg, 1979, 3(1): 67-79, 128-129.
13.	唐举玉, 俞芳, 吴攀峰, 等. 去细胞同种异体神经移植修复桡神经和指神经缺损六例. 中华显微外科杂志, 2014, 37(5): 449-452.
14.	王源瑞, 张振军, 冷永德, 等. 神经桥接与神经端侧缝合修复周围神经缺损的研究进展. 中华创伤骨科杂志, 2006, 8(11): 1072-1075.
15.	Millesi H. Techniques for nerve grafting. Hand Clin, 2000, 16(1): 73-91.
16.	李锦永, 胡洪良, 王换新, 等. 腓肠神经移植修复桡神经深支缺损的疗效分析. 中华显微外科杂志, 2013, 36(2): 183-185.
17.	王世炜, 刘松. 周围神经损伤修复的研究进展. 中华神经外科杂志, 2014, 30(4): 419-422.
18.	崔殿生, 胡礼泉, 李世文, 等. 腓肠神经移植重建海绵体神经保留勃起功能的实验研究. 中华男科学杂志, 2005, 10(5): 330-333.

1. Tullii RE, Ferreira R, Vaccari R. Neurotomy: a new thera-peuticechnique for primary premature ejaculation. Proceeding of the 4thAsia-Pacific Impotencea Meeting, 1993: 134-135.
2. Lee YS. Effect of dorsal nerve neurotomy in patients with premature ejaculation. Programme&Abstracts of China-Korea Medical Conference’97. 1997: 380.
3. 郭应禄. 阴茎勃起功能障碍. 北京: 北京医科大学出版社, 1999: 58-59.
4. 邓立文, 涂响安, 邓春华, 等. 慢性前列腺炎患者性功能状况与精神症状调查研究. 中国临床实用医学, 2007, 1(9): 5-7.
5. 薛珺, 汪静宇, 陈利生, 等. 早泄的研究进展. 中华男科学杂志, 2007, 13(1): 65-68.
6. American Psychiatric Association. Diagnostic and statistical manual ofmental disorders. 4th eds. Text Revision. Washington DC: American Psychiatric Association, 2000: 68.
7. Montague DK, Jarow J, Broderick GA, et al. AUA guideline on thepharmacologic management of premature ejaculation. J Urol, 2004, 172(1): 290-294.
8. Althof SE, McMahon CG, Waldinger MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med, 2014, 11(6): 1392-1422.
9. Althof SE, Abdo CH, Dean J, et al. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med, 2010, 7(9): 2947-2969.
10. 孙中义, 李彦锋, 周波, 等. 阴茎背神经选择性切断术提高阴茎感觉阈值的临床分析. 中国男科学杂志, 2010, 24(10): 46-48.
11. 顾玉东. 周围神经缺损的基本概念与治疗原则. 中华手外科杂志, 2002, 18(3): 129-130.
12. Millesi H. Microsurgery of peripheral nerves. World J Surg, 1979, 3(1): 67-79, 128-129.
13. 唐举玉, 俞芳, 吴攀峰, 等. 去细胞同种异体神经移植修复桡神经和指神经缺损六例. 中华显微外科杂志, 2014, 37(5): 449-452.
14. 王源瑞, 张振军, 冷永德, 等. 神经桥接与神经端侧缝合修复周围神经缺损的研究进展. 中华创伤骨科杂志, 2006, 8(11): 1072-1075.
15. Millesi H. Techniques for nerve grafting. Hand Clin, 2000, 16(1): 73-91.
16. 李锦永, 胡洪良, 王换新, 等. 腓肠神经移植修复桡神经深支缺损的疗效分析. 中华显微外科杂志, 2013, 36(2): 183-185.
17. 王世炜, 刘松. 周围神经损伤修复的研究进展. 中华神经外科杂志, 2014, 30(4): 419-422.
18. 崔殿生, 胡礼泉, 李世文, 等. 腓肠神经移植重建海绵体神经保留勃起功能的实验研究. 中华男科学杂志, 2005, 10(5): 330-333.

Chinese Journal of Reparative and Reconstructive Surgery

Efficacy evaluation of sural nerve bridging transplantation for restoration of penis disturbance of sensation after selective dorsal nerve neurotomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content