袖套式包皮环切术联合Z改形治疗包皮过长

Detachable Sleeve Circumcision Combined with Z-Plasty in Treating Phimosis

目的介绍袖套式包皮环切术联合Z改形关闭切口治疗包皮过长与包茎的方法和效果。方法 1%利多卡因阴茎根部浸润麻醉后,根据包皮过长的程度单纯去除相应包皮内、外板的皮肤层,保留完整的肉膜,如果局部存在环形筋膜缩窄环则给予适当松解,缝合时在切口两侧各作1个Z成形术关闭切口。结果利用该术式治疗包皮过长、包茎20例,术中出血少,术后组织水肿反应轻,并发症少,效果满意。结论袖套式包皮环切术联合切口Z改形关闭切口治疗包皮过长具有手术创伤轻、术后组织水肿轻微,切口愈合快,愈合后皮肤不与白膜粘连或出现切口瘢痕挛缩等优点。

Objective To introduce a new method of circumcision combined with Z-plasty and its effect in treating phimosis by keeping the Buck’s and Colle’s fascia from removal.Methods After 1% lidocaine was injected superficially to the tunica albuginea around the penile root,the excess skin at both the inner and external lamina of the foreskin was removed while dartos was kept intact,except in case of a circumferential contracture,some longitudinal incision was made within the dartos to release the contracture.A Z-plasty was also used to prevent the circumferential contraction when suturing.Results Twenty cases of phimosis were treated by this method with a satisfactory result including less hemorrhage during operation,less swelling postoperatively and less complications.Conclusion The detachable sleeve circumcision with Z-plasty has the following superiorities in treating phimosis： less operative injury,less swelling after operation,no adhesion of the foreskin to the tunica albuginea,neither the contracture of the incisional scar.