先天性隐匿性阴茎的外科治疗

Surgical treatment of congenital concealed penis

目的探讨先天性隐匿性阴茎的手术治疗方法,提高对该疾病的认识以及临床治疗的效果。方法对15例先天性隐匿性阴茎患儿采用改良Devine术式手术矫正,平均年龄10.5岁,既往均无阴茎手术史,术中将阴茎包皮脱套至阴茎根部,识别并剔除阴茎体部发育不良的条索状组织,术后对所有患者进行随访。结果本组患者术后随访3～12个月,手术均获得成功,无一例复发,无皮肤缺血、血肿、勃起疼痛等并发症,术后阴茎显露及外观满意,发育良好,排尿及勃起功能正常。2例患者术后包皮出现轻度淋巴回流障碍,数月后自然消退。结论应严格区分真性隐匿性阴茎与埋藏阴茎、小阴茎、包皮过长,选择合适的手术方法可获得满意疗效。本术式纠正了隐匿性阴茎的病理改变,术后阴茎功能和形态良好,是治疗隐匿性阴茎的理想术式,值得推广。

Objective To explore the surgical operation of congenital concealed penis, and raise the therapeutic efficacy. Methods A total of 15 patients（median age 10.5 years） with concealed penis were treated by the modified Devine surgery. All 15 patients did not have previously surgery for penis. Prepuce of penis was completely degloved to the root of penis as usual with a circurrderential coronal incision. The dysplastic trabsshape tissue was recognized and removed. All eases of concealed penis were reviewed retrospectively. Results All the patients were fowned for at least 3 months postoperatively. All patients were satisfied with penis contour, normal pass urine exection and no any complications, like skin ischemic, haematoma and erection ache, 2 patients presented with mild lymphatic stasis of distal shaft that spontaneously subsided within a few months. Conclusion The real concealed penis should be strictly distinguished from buried penis, microphallus and redundant prepuce, and suitable operation pattern could obtain satisfactory effect. The function of the penis was satisfactory. This surgery was an ideal procedure for concealed penis with easy bleeding control, avoiding the use of flaps, grafts, and additional ventral Z plasty. In addition, the cosmetic results were judged to be good by the patients.