RU2269308C1 - Method for testicular prosthetics at monorchism and anorchism - Google Patents

Abstract

FIELD: medicine, surgery, urology.

SUBSTANCE: one should perform scrotal incision to carry out scrotal correction with the help of a dissector under the skin and a fleshy muscle. Then one should introduce an egg-shaped implant into scrotal cavity at its size being 40±2x30±2x20±2 mm. This implant is designed due to disordered application of nickelide-titanium ligature of 60-90 mcm thickness. Implant is covered with nickelide-titanium netting at cells size being 1-4 mm. The innovation enables to provide biocompatibility of implantation material with body tissues, develop a testicle of normal shape and consistence.

EFFECT: higher efficiency of testicular prosthetics.

3 dwg, 1 ex

Description

The invention relates to medicine, namely to surgery, urology, traumatology, and can be used for prosthetics of the testicles with monorchism and anorchism.

The closest technical solution is a testicular prosthesis for monorchism and anorchism, in which the corresponding half of the scrotum is corrected through a puncture of the scrotum and the sterile hydrogel PLAG of the 6th density is introduced to the depth of the zone between the scrotum and the meaty membrane, and the wound is sutured.

The disadvantage of this method is the lack of biocompatibility of the implantation material with body tissues, as well as the difficulty of forming a normal shape and consistency of the testicle.

The task of the invention is to increase the effectiveness of prosthetic testes for monorchism and anorchism.

The problem is achieved in that in the method of prosthetics of the testicles with monorchism and anorchism, including scrotal incision, correction of the corresponding half of the scrotum using the dissector under the skin and fleshy muscle, suturing of the wound, new is that nickel-titanium is placed under the scrotum and fleshy muscle an egg-shaped implant with a size of 40 ± 2 × 30 ± 2 × 20 ± 2 mm, made by tight disordered cross-laying of nickel-titanium filament 60-90 μm thick, coated with a mesh of titanium nickelide with a mesh size of 1-4 mm.

The proposed method for prosthetics of the testicles with monorchism and anorchism allows to eliminate a cosmetic defect of the external genitalia with a high degree of effectiveness. Due to the biochemical and biomechanical compatibility of titanium nickelide with body tissues, the connective tissue from the side of the recipient zone grows through the structure of the implant, forming a connective tissue regenerate that is unified with the implant material. Cross dense disordered laying of the thread, placed in a mesh structure, allows you to give the structure elastic properties that are as close as possible to a normal testicle. The mesh size of the cells ensures the preservation of a given implant shape and retention of tissue fluid.

The method is as follows. Under general or local anesthesia in the root area of the scrotum, the skin and underlying tissues are cut, including fleshy muscle, 1.5 cm long, with the help of a dissector they form a cavity in the scrotum, the volume corresponding to the missing testicle, where a nickel-titanium egg-shaped implant, size 40 ± 2 × 30 ± 2 × 20 ± 2 mm, made by tight disordered cross-laying of titanium nickelide filament 60-90 μm thick, covered with a mesh of titanium nickelide with a mesh size of 1-4 mm, the wound is sutured.

Example. Patient D., 20 years old, was admitted with a diagnosis of right-sided monarchism. From the anamnesis: a year ago, as a result of an injury, the right testicle was removed. Under local anesthesia in the scrotum root, a skin incision was made along with the underlying tissues and fleshy muscle 1.5 cm long, with the help of a dissector, a cavity was created in the scrotum, corresponding in volume to the missing testicle, where an egg-shaped nickelide-titanium implant made by dense disordered cross-laying of nickel-titanium filament 80 μm thick, covered with a mesh of titanium nickelide with a mesh size of 3 × 4 mm, a length of 40 mm, a width of 30 mm, a thickness of 20 mm, the wound was sutured. The postoperative period was uneventful. The patient was discharged in satisfactory condition. When viewed after 3 years, the condition of the external genitalia is satisfactory.

Figure 1 shows the endoprosthesis of the testis, figure 2 shows the condition of the external genital organs of patient D. before implantation, figure 3 shows the state of the external genital organs of patient D. 3 years after implantation.

The advantages of the proposed method is that as a result of the use of a nickel-titanium implant, in shape, size and elasticity corresponding to a normal testicle and formed a dense connective tissue regenerate uniform with the implant material, highly effective removal of cosmetic defects of the external genital organs is provided. The biochemical and biomechanical compatibility of this implantation material with body tissues excludes its resorption and rejection, as well as the complications arising from this.

Clinical trials of the proposed method were carried out on 5 patients. No complications were observed. The method is recommended for practical use.

Claims (1)

A method of testicular prosthetics for monorchism or anorchism, including a scrotum incision, correction of it with a dissector under the skin and fleshy muscle with the introduction of an implant, characterized in that an egg-shaped implant of 40 ± 2 × 30 ± 2 × 20 ± 2 mm in size is inserted into the scrotum cavity by randomly stacking nickel-titanium filament 60-90 microns thick, coated with a nickel-titanium mesh with a mesh size of 1-4 mm.

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