台北男性泌尿专科：微创手术、勃起功能障碍与早泄诊疗
谢政兴泌尿科诊所标志 谢政兴泌尿科诊所 UroKingdom Urology Clinic 台湾全民健康保险特约医疗机构
← 浏览所有卫教文章

人工阴茎植入手术

检查、手术与照护｜ 更新于 2026-09-21

手术原理

生理性勃起时，血液经由阴茎动脉灌注进入两侧阴茎海绵体内，使其充血膨胀。海绵体外侧被坚韧的白膜包裹，同时压迫静脉阻滞血液流出，从而产生坚挺充盈的勃起。

对于重度难治性勃起功能障碍（ED）患者，在口服药物、体外冲击波或注射等保守治疗无效时，人工阴茎植入手术（Penile Prosthesis Implantation）是最终确实有效的终身治疗方案。手术将人工阴茎体植入阴茎海绵体腔内，取代病损海绵体，仍包覆在原有白膜内。术后阴茎可获得充足硬度以进行正常性生活，外观与触感逼真自然，且完整保留射精、性高潮及皮肤敏感度。

麻醉方式：双重局部麻醉

传统手术通常在椎管内半身麻醉或全身麻醉下完成。

本院采用创新双重局部麻醉技术，涵盖背神经近端阻滞、阴茎脚阻滞及基底浸润阻滞，仅在阴茎根部注射局部麻醉药物（图1）。手术全程患者意识清晰且无疼痛，可轻松操作手机或佩戴蓝牙耳机听音乐。

图1：双重局部麻醉技术，仅在阴茎根部注入局麻药，包括阴茎背神经近端阻滞、阴茎脚阻滞与根部浸润阻滞。

手术切口与住院说明

切口常位于龟头冠状沟下方、耻骨部或阴囊阴茎交界处，长度约3厘米。无需住院留观，属于门诊日间手术，术后即可自行步行离院回家休养。

手术步骤与装置类型

1. 半硬可折式人工阴茎：植入两支内含合金轴芯的医用硅胶体柱，术后约2个月恢复期后，即可手持向上扳起进行性生活（图2C、图3A），事后向下折弯贴合隐蔽（图2D、图3B）。机械耐用度高，无机械故障风险。

图2：A) 海绵体切开并植入合宜长度假体 B) 细微缝线缝合白膜 C) 向上扳起 D) 向下折弯隐蔽
图3：A) 向上折起即可过性生活 B) 完事后向下折弯隐蔽。

2. 三件充水式人工阴茎（三件套 IPP）：由海绵体内充水圆柱体、阴囊调水泵与耻骨后储水囊三部分组成（图4）。捏挤阴囊内的液压泵即可使液体注入柱体膨胀充盈（图5A）；按下释放阀液体流回储液囊，恢复自然疲软（图5B）。仿真度与生理体验好。

图4：三件充水式人工阴茎位置布局：圆柱体、阴囊泵与耻骨后储水囊。A) 充水挺立 B) 泄水疲软。
图5：A) 挤压阴囊水泵充水直挺 B) 按压阀门恢复自然下垂疲软。

避免电刀止血 · 微创显微解剖保护

本院严格实行不使用电灼止血，采用细微缝线逐一结扎止血，避免高温对神经血管束产生热损伤，防止神经麻木与慢性疼痛。最大程度保留组织血供，提高抗感染能力，促进切口愈合。

手术预后与满意度

多中心临床随访显示，人工阴茎手术患者及其伴侣的满意度普遍超过 85%。糖尿病患者术前须将糖化血红蛋白控制在合适范围（HbA1c < 8%）以确保安全、减少感染风险。

假体类型手术特点优点与考量
半硬可折式手术时间短，操作相对简明优点： 构造坚固耐用，几乎无机械故障。
考量： 初期稍有硬物感，一般数周内逐渐适应。
三件充水式手术精密，技术门槛高优点： 勃起硬挺与疲软下垂切换自如，极为自然逼真。
考量： 构造精密，长期使用存在耗损维护可能。

期刊论文

  1. Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Chen YC, Liu LJ, Mok MS, Wu CH. Outpatient penile implantation with the patient under a novel method of crural block (以新的陰莖腳局部麻醉方法施行陰莖植入門診手術). International Journal of Andrology. 27:147-151, 2004.
  2. Hsu GL, Hsieh CH (謝政興), Chen HS, Ling PY, Wen HS, Liu LJ, Chen CW, Chua C. The advancement of pure local anesthesia for penile surgeries: can an outpatient basis be sustainable (純粹局部麻醉施行陰莖手術的新進展)? Journal of Andrology. 28(1):200-205, 2007.
  3. Hsu GL, Zaid UX, Hsieh CH (謝政興), Huang SJ. Acupuncture assisted local anesthesia for penile surgeries (針灸輔助局部麻醉下施行陰莖手術). Translational Andrology and Urology. 2(4):291-300, 2013.
  4. Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Chen YC, Chen RM, Chen SC, Hsieh JT. The effect of electrocoagulation on the sinusoids in the human penis (電燒止血對於人類陰莖海綿體的影響). Journal of Andrology. 25(6):954-959, 2004.
  5. Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Wu CH, Fong TH, Chen SC, Tseng GF. Anatomy of the human penis: the relationship of the architecture between skeletal and smooth muscles (人類陰莖解剖構造：骨骼肌和平滑肌之間的結構關係). Journal of Andrology. 25:426-431, 2004.
  6. Hsieh CH (謝政興), Liu SP, Hsu GL, Chen HS, Molodysky E, Chen YH, Yu HJ. Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: Clinical implications for physicians and surgeons (了解哺乳類動物的陰莖進化、人類陰莖解剖學和人類勃起生理學方面的進展：對於內外科醫生的臨床意涵). Medical Science Monitor. 18(7): RA118-125, 2012.
  7. Hsu GL, Hsieh CH (謝政興), Chen SC. Human penile tunica albuginea: anatomy discovery, functional evidence and role in reconstructive and implant surgery (人類陰莖白膜：解剖學發現、功能上證據和在重建及人工陰莖植入手術中的角色). Global Advanced Research Journal of Medicine and Medical Science. (GARJMMS) 3(12):400-407, 2014.
  8. Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Chen SC, Mok MS. Penile venous anatomy: an additional description and its clinical implication (陰莖靜脈解剖構造：附加描述及其臨床意涵). Journal of Andrology. 24(6):921-927, 2003.
  9. Hsu GL, Wen HS, Hsieh CH (謝政興), Liu LJ, Chen YC. Traumatic glans deformity: reconstruction of distal ligamentous structure (外傷性龜頭畸形：重建遠端韌帶結構). Journal of Urology. 166:1390, 2001.
  10. Hsu GL, Lin CW, Hsieh CH (謝政興), Hsieh JT, Chen SC, Kuo TF, Ling PY, Huang HM, Wang CJ, Tseng GF. Distal ligament in human glans: a comparative study of penile architecture (人類龜頭遠端韌帶：一項比較研究陰莖結構). Journal of Andrology. 26(5):624-28, 2005.
  11. Hsu GL, Hill JW, Hsieh CH (謝政興), Liu SP, Hsu C. Venous ligation: a novel strategy for glans enhancement in penile prosthesis implantation (靜脈綁紮手術: 人工陰莖植入手術時增大龜頭的新方法), in Genitourethral Reconstruction, Ralf Herwig R, Sansalone S, Rehder P, Editors. BioMed Research International. Published special issue, Article ID923171, 7 pages, 2014.
  12. Hsieh CH (謝政興), Hsu GL, Chang SJ, Yang SSD, Liu SP, Hsieh JT. Surgical niche for the treatment of erectile dysfunction (手術治療勃起功能障礙的利基). International Journal of Urology. 27(2):117-133, 2020.

书籍著作

  1. Cheng-Hsing Hsieh (謝政興)、Geng-Long Hsu (許耕榕). 治療勃起功能障礙 – 手術治療(Erectile Dysfunction – Surgical Management).書名：男性性功能障礙 – 臨床診治全攻略 (Male Sexual Dysfunction – A Complete Guide to Diagnosis and Treatment), 陳煜、簡邦平、蔡維恭、陳卷書編輯. 合記圖書出版社, 2023. 第三篇，第17章，頁245-262.
  2. Cheng-Hsing Hsieh (謝政興)、Geng-Long Hsu (許耕榕). 勃起功能障礙 – 手術治療 (Erectile Dysfunction – Surgical Treatment). 書名：臨床泌尿學 (CLINICAL UROLOGY). 郭漢崇、賴明坤、楊啟瑞、黃一勝、余燦榮、陳進典、崔克宏,編輯. 台灣泌尿科醫學會, 2012.第八篇，第54章，頁1037-1049.
  3. Geng-Long Hsu (許耕榕)、Cheng-Hsing Hsieh (謝政興). 書名：A LABORATORY MANUAL FOR POTENCY MICROSURGERY (性功能顯微手術實驗訓練手冊). 許耕榕、謝政興,編輯.

参考文献

  1. Goodwin WE, Scott WW. Phalloplasty. J Urol. 1952; 68: 903.
  2. Beheri GE. Surgical treatment of impotence. Plast Reconstr Surg. 1966; 38: 92.
  3. Pearman RO. Insertion of a silastic penile prosthesis for the treatment of organic sexual impotence. J Urol. 1972; 107: 802-806.
  4. Small MP, Carrion HM, Gordon JA. Small-Carrion penile prosthesis: new implant for management of impotence. Urology 1975; 5: 479.
  5. Finney RP. New hinged silicone penile implant. J Urol 1977; 118: 585-587.
  6. Jonas U, Jacobi GH. Silicone-silver penile prosthesis: description, operative approach and results. J Urol. 1980; 123: 865-867.
  7. Scott FB, Bradley WE, Timm GW. Management of erectile impotence: use of implantable inflatable prosthesis. Urology. 1973; 2: 80-82.
  8. Furlow WL. Inflatable penile prosthesis: Mayo clinic experience with 175 patients. Urology. 1979; 13: 166-171.
  9. Montague DK. Experience with semirigid rod and inflatable penile prostheses. J Urol. 1983; 129: 967-968.
  10. Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA guideline. 2018;https://www.auanet.org/guidelines/non-oncology-guidelines/sexual-and-reproductive-health.
  11. Hellstrom WJG, Montague DK, Moncada I, et al. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med. 2010; 7:501-523.
  12. Wilson SK, Carson CC, Cleves MA, et al. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin. J Urol. 1998; 159:1537–1539. discussion 9–40.
  13. Chiang HS, Wu CC, Wen TC. 10 years experience with penile prosthesis implantation in Taiwanese patients. J Urol. 2000; 163: 476-480.
  14. Wilson SK, Delk JR, Salem EA, Cleves MA. Long-term survival of inflatable penile prostheses: single surgical group experience with 2384 first-time implants spanning two decades. J Sex Med. 2007; 4:1074-1079.
  15. Brant MD, Ludlow JK, Mulcahy JJ. The prosthesis salvage operation: immediate replacement of the infected penile prosthesis. J Urol. 1996; 155: 155-157.
  16. Mulcahy JJ. Treatment alternatives for the infected penile implant. Int J Impot Res. 2003; 15(Suppl 5): S147-149.
  17. Barton, G. J., Carlos, E. C., & Lentz, A. C. (2019). Sexual quality of life and satisfaction with penile prostheses. Sexual Medicine Reviews, 7(1), 178–188.
  18. Salonia, A., Bettocchi, C., Boeri, L., et al. (2023). European Association of Urology guidelines on sexual and reproductive health. European Urology, 84(1), 1–54.

有泌尿或男性健康方面的困扰吗？

由谢政兴医师亲自评估。网络预约不开放当日门诊。

LINE 在线咨询