Schroeder-Essed术治疗先天性单纯阴茎弯曲

Schroeder-Essed surgical procedure for the treatment of congenital penile curvature

目的探讨Schroeder-Essed术治疗单纯性阴茎下屈畸形的疗效。方法回顾分析1999年1月至2009年7月收治的尿道开口正常的阴茎下屈畸形患者21例,年龄3～42岁,平均13.3岁,下弯平均约15°～90°,平均45。,侧弯1例约40°。均采用Schroeder-Essed术辅以阴茎皮肤脱套的手术方法,必要时结合尿道游离以及尿道成形术治疗。结果手术后阴茎弯曲完全纠正20例,Ⅰ型3例矫正阴茎弯曲后利用阴茎背侧包皮行Duckett尿道成形术。Ⅱ型和Ⅲ型共17例、Ⅳ型1例经Schroeder-Essed术辅以阴茎皮肤完全脱套术弯曲得到完全矫正。术后近期并发症主要为疼痛、尿道不适;远期并发症为尿瘘1例,局部皮肤感染1例,残留下弯1例(约15°)但不影响正常性生活。随访6～25个月,疗效满意。2例成年患者性生活正常。结论 Schroeder-Essed术结合阴茎皮肤脱套技术能矫正大多数单纯阴茎弯曲畸形,简便易行、并发症少,是治疗轻中度单纯阴茎下屈畸形的良好方法。

Objective To investigate the effects of Schroeder-Essed surgical procedure for the treatment of congenital penile curvature. Methods Total of 21 patients with congenital penile curvature from January of 1999 to July of 2009 was analyzed retrospectively. All patients were treated by Schroeder-Essed surgical procedure supplemented with degloving of penile shaft, if nesenssary, with urethral division and urethroplasty. Results Seventeen cases of type Ⅱ and Ⅲ congenital penile curvature, as well as one case of type Ⅳ congenital penile curvature were succesfully repaired by Schroeder-Essed surgical procedure supplemented with degloving of penile shaft penile dorsal tunical plication Three cases of type Ⅰ congenital penile curvature were repaired by penile dorsal tunical plication Duckett urethroplasty, One case had a complication of urethroeutaneous fistula after urethroplasty, which was succesfully repaired 6 month later; One case had a complication of local infection of skin. All 21cases were followed up for 13 months （range 6 to 25 months）. Twenty cases all had complete straight penis and one case had mild curvature with less than 15 degree. Conclusion Schroeder-Essed surgical procedure is a better surgical method with minimal complications for the treatment of congenital islated penile curvature.