Brisson术矫治小儿隐匿阴茎

Brisson technique for correction of buried penis in children

目的探讨小儿隐匿阴茎的病因、病理改变、诊治方法,以提高对该病的认识和治疗效果.方法对52例平均年龄4岁8个月的隐匿阴茎患儿采用Brisson矫治术.患儿临床表现为阴茎外观短小,皮肤表面仅见包皮堆积,扪不到阴茎体,指压阴茎皮肤可显露发育正常的阴茎体,有包茎和阴茎皮肤发育不良,其中合并肥胖8例.结果患儿术后阴茎显露良好,疲软时阴茎显露长度平均(3.56±0.49)cm.术后发生轻度包皮水肿16例,7～10 d恢复.家长和患儿对效果满意.随访2～12个月,无1例复发,阴茎发育好.结论阴茎肉膜发育异常,束缚阴茎外伸是小儿隐匿阴茎的主要病理改变.早期手术治疗能改善外观和解决包皮阴茎头炎及反复尿路感染等临床症状,避免对患儿及家长造成不必要的心理损害.Brisson术治疗,术后并发症少,外观满意,是治疗小儿隐匿阴茎的理想术式.

Objective To investigate the etiology, pathology, diagnosis and surgical treatment of buried penis so as to improve the level of understanding and management of this disease. Methods Brisson＇ s technique was performed in 52 children with buried penis aged from 3 months to 14 years （ mean, 4.7 years）. All the children presented with a buried penis, defined as a normal shaft length that was completely obscured by abnormal attachment of the penile skin to the penile shaft. The normal shaft length was visualized by digital compression of the skin superiorly and inferiorly to the penis. All the children had phimosis and dysgenic penile shaft skins. Eight of them were obese. Results Postoperatively,all the children had good outcomes with a low complication rate and increased visualization of the penile shaft [ mean, （3.56±0.49）cm]. Mild edema of prepuce occurred in 16 children and they recovered in 7 - 10 days. Follow-up of 2 - 12 months showed no recurrent retraction of the penile shaft. The development of the penis was good. Conclusions The main pathological change of this disease was the restriction of dysgenic Dartos fascia. Operation should be performed early. There are psychological benefits to the children and their parents. Brisson＇ s technique provides immediate excellent cosmetic effects with a low complication rate. It is an ideal surgical technique for buried penis in children.