Workshop application

題目:

源自台灣大學之臺製男性功能重建諸術與陰莖纖維血管總成的交互轉譯

許耕榕 ¹、謝宜穎 ²、鍾卓興 ³、陳明村 ⁴、闕士傑 ²

¹ 埔里基教醫院 顯微男性功能重建暨研究中心 ; ²臺灣大學附設醫院泌尿部

; ³臺北醫學大學萬芳醫院泌科; ⁴書田泌尿科眼科診所

Theme:

Translate Benchside to Bedside of Various Surgical Strategies for Male Potency Reconstructions and Vice Versa

Geng-Long Hsu^1,2,4, Yi-Ying Hsieh², Cho-Hsing Chung³, Ming-Tsun Chen⁴, Jeff SC Chueh²

1 Puli Christian Hospital, Microsurgical Potency Reconstruction and Research Center, Puli

Township, Nantou, Taiwan

² Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

³ Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

⁴ Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology, and Shu-Tien

Urology Ophthalmology Clinic, Taipei, Taiwan

Backgrounds

Human beings visited this earth 3000 years ago, as do the penile anatomy and erection issues, which are likely requiring improvement. However, related studies have been attempted in the last 6 centuries. Penile fibro-vascular anatomy prevailed over the conventional portrayal, presumed by Leonardo da Vinci between 1452 and 1519. This traditional version illustrates a single circumferential tunica albuginea (TA) encasing paired hydraulic corpora cavernosa (CC), with a single deep dorsal vein (DDV) draining penile corporal blood. Over the course of our decades of effort, we have conducted a detailed analysis of penile fibro-vascular assembly, which comprises a penile fibroskeleton and intriguing erection-related veins. The fibroskeleton includes a bi-layered TA that surrounds the hydraulic CC, with a 360° inner circular and a 300° outer longitudinal coat with a dorsal fenestrated medium septum. The inner layer completely encloses the sinusoids and extends intracavernous pillars to support them, which are enveloped in a cavernosal membrane. The outer layer, a defined structure for the penile prosthesis protector and penile morphology, aggregates to form a distal ligament within the glans penis, ensuring rigidity and guarding patency during ejaculation as required. The erection-related veins involve one DDV, two cavernosal veins (CVs), and four para-arterial veins between TA and Buck’s fascia. This innovation model is an example of translation medicine (TM). It is also a form of reverse TM, as evidenced by numerous reciprocations from bench to bedside, using multiplanar approaches that include anatomical, physiological, radiological, and surgical resources, since 1985. Given that anatomical knowledge is a prerequisite for surgery, we have developed various strategies for male potency reconstruction since 1986. Here, we are honored to host a workshop that supports our aim of sharing and reproducing the work of young colleagues.

Objectives: To report our innovative understanding of penile anatomy and various reconstructive strategies, we sought to present our outcomes.

Materials and Methods: Re-examination was made on decades’ repository conducted retrospective research design, a de novo penile fibroskeleton —a penile vascular model that clearly depicts the erection-related venous system —and, eventually, the entire penile fibro-vascular assembly, along with an exclusive physiological method of penile venous stripping, were confirmed from 1985 to 2025. Our vast repository of data was revisited, including a revolutionary model of penile fibro-vascular assembly, hemodynamic studies on fresh and defrosted human cadaveric penises, and translational male potency reconstructive strategies since 1986. These include ambulatory penile venous stripping, penile morphology reconstruction, combined penile venous stripping and morphology reconstruction, penile implant with glans enhancement, penile implant with glans enhancement and factual penile girth enhancement.

Results: As a retrospective study, three speakers are honorably presenting research and surgical approaches for a multiplanar niche, including Geng-Long Hsu for a revolutionary human penile fibro-vascular assembly and an apagogical erection mechanism, Yi-Ying Hsieh for ambulatory human penile fibro-related reconstructive strategies, and Cho-Hsing Chung for ambulatory human penile vascular-related reconstructive strategies. Conspicuously, penile venous stripping has extended to patients with spinal cord injury and prostatectomy-induced erectile dysfunction.

Conclusion: Given that practice is the only criterion for testing the truth, so does medical practice; these historically refined issues deserve reevaluation and sharing with younger generations.