隐匿阴茎不同术式的疗效比较

Comparison of different surgical techniques for treatment of concealed penis

目的探讨隐匿阴茎不同术式的疗效。方法回顾性分析1986—2007年手术治疗219例隐匿阴茎患儿临床资料。年龄3～15（10．3±2．4）岁。术前测量阴茎外露长度0．5～3．0（119±0．5）cm，其中重度93例，中度126例。采用Johnston术34例，Devine术42例，改良Devine术125例，Brisson术18例。比较4种术式患儿术后阴茎长度增加的差异。结果Johnston术、Devine术、改良Devine术和Bfisson术患儿术后阴茎外露增加长度分别为（1．8±0．4）、（2．0±0．5）、（2．1±0．4）和（2．3±0．4）cm，组间差异有统计学意义（F=13．1，P〈0．001）。Devine术、改良Devine术和Bfisson术效果优于Johnston术。4种术式术后发生顽固性阴茎皮肤水肿患儿分别为8、5、6和2例。结论隐匿阴茎的形成与阴茎皮肤浅筋膜发育异常有关。改良Devine术式疗效良好，术后并发症少。

Objective To compare the effects of different surgical techniques for treatment of concealed penis. Methods A retrospective review of 219 patients underwent surgical correction of concealed penis between 1986 and 2007 was performed. The mean age was （10.3±2.4）years（3-15 years）. The penile length was （1. 9±0.5）cm（0. 5 -3. 0 cm） before operation. Ninty three patients were the severe degree of concealed penis. The others were the moderate degree. All patients under went operation with different techniques, including Johnston＇s technique in 34, Devine＇s technique in 42, modified Devine＇s technique in 125 and Brisson＇s technique in 18. The increased length of penile after operation was compared among the 4 groups with different surgical techniques by statistical method. Results The postoperative increased length of penile in Johnston＇s technique, Devine＇s technique, modified Devine＇s technique and Brisson＇s technique was （1. 8 ± 0. 4）cm, （2. 0 ± 0. 5）cm, （2.1±0.4）cm and （2.3±0.4）cm respectively. The difference was significant by ANOVA test （F= 13.1,P〈0. 001 ）. Devine＇s technique, modified Devine＇s technique and Brisson＇s technique were better than Johnston＇s technique considering the increased length of penile. The complication of severe penile lymphedema of 4 groups developed in 8, 5, 6 and 2 patients respectively. Conclusion Modified Devine＇s technique has the satisfactory increasing of penile length for treatment of concealed penis and less complication rate after operation.