阴茎折断诊断及手术疗效长期观察(附9例报告并文献复习)

Diagnosis and long term outcomes of surgical treatment of penile fracture(Report of 9 cases)

目的：探讨阴茎折断的诊断及手术治疗的长期效果。方法：回顾1993～2006年间9例行手术治疗的阴茎折断病例，患者年龄20～40岁，平均32．5岁；术后随访6～132个月，平均53个月。另选取5例健康已婚男性作对照。通过国际勃起功能指数（IIEF-5）问卷调查，探讨手术对勃起功能的长期影响。结果：9例患者皆通过临床表现确诊。8例（88．8％）阴茎外观正常且勃起功能未受任何影响，1例（11．1％）发生阴茎轻度弯曲，所有患者皆未发生勃起功能障碍。9例患者的IIEF5平均评分为（21．3±2．5）分，对照组IIEF-5平均评分为（22．4±2．2）分，二者比较差异无统计学意义（P〉0．05）。实验组阴茎的勃起硬度和勃起能力方面的IIEF评分较高（P〈0．05）。结论：手术疗法对阴茎折断后勃起功能的恢复疗效确切且安全可靠，在阴茎折断的治疗中值得推荐。

Objective：To determine the diagnosis and long term outcome of the surgical management of penile fracture. Methods：Clinical data of 9 cases of patients （mean age 32.5 years, range 20-40） with penile fracture undergoing surgery between April 1993 and December 2006 were reviewed. Long term potency （〉6 months after surgery） was evaluated using the International Index of Erectile Function （IIEF 5） questionnaire. A control group of 5 men also completed the IIEF 5. The mean （median, range） follow up after injury was 53 （61, 6-132） months. Results： All patients were diagnosed by clinical presentation. Satisfactory and painless erectile function with a soft straight penis was reported by 8 patients （88.8%）. Only one patient （11.1%）occurred moderate penile curvature. None of 9 patients occurred erectile dysfunction （ED）. In sexually active participants, the mean IIEF 5 score for 9 patients was （23.2±2.7） and not significantly different from that of 5 controls （22.8±2.1）. However, patients had higher scores than controls for erectile firmness and maintenance ability （P〈0.05）. Conclusions：Surgery for a fractured penis is safe and effective. Surgical treatment is very satisfactory for patients and partners. Considering these encouraging results, surgical intervention is strongly recommended.