改进阴茎根部皮肤环切术治疗包皮过长的临床经验体会

Experience of the improvement of circumcision at the base of the penis

目的利用改进的方法进行阴茎根部皮肤环切术治疗包皮过长,并进行临床观察。方法根据整形美容的原则,该院采用改进的方法进行阴茎根部皮肤环切术：①术前在阴茎完全勃起的状态下标记切口线,准确设计一条背宽腹窄的环形阴茎根部皮肤为切除范围。并在两条切口线12、2、4、6、8、10点的位置标记六个对应点。②采用局部浸润麻醉,于皮下浅筋膜表面剥离,保留筋膜、血管、神经的完整;③缝合时,先于12、2、4、6、8、10点定位缝合6针,提起相邻的两牵引线,采用由中间向两边平分的方法进行缝合;④皮肤缝线打结后留长线头,将窄条状凡士林纱布敷于两线头之间,线头再次打结以固定环形凡士林纱布,然后以自粘弹力绷带螺旋式包扎。结果 52例患者效果良好,无血肿、包皮游离缘水肿、感染、延迟愈合、瘢痕增生、切口环形狭窄等并发症发生,术后外观与正常无异,随访6~12月,性生活满意,无特殊后遗症。结论该术式与常规阴茎根部环切术式比较,效果更好。

【Objective】 Application a improved technology of the circumcision at the base of the penis for the treatment of redundant prepuce and make clinical observation.【Methods】 According to principles of plastic and aesthetic surgery,we designed a improved technology of the circumcision at the base of the penis： ①Drawing two lines of incision to confirm skin in proper width at the base of the penis was resected based on the length of the penile erected completely before operation.Drawing at 12,2,4,6,8,and 10 o＇ clock positions of two lines.②Dissection on the surface of subcutaneous supper fasia under local anesthesia.Existing skin only,maintaining nerve,vessel and fascia.③Anchoring suture was performed at 12,2,4,6,8,10 o＇ clock positions,adding interrupted suture to close the wound.④After suture the long stitches were preserved to fix the sterile gauze then pressed on dress.【Results】 52 patients achieved satisfactory results.There was no complication like hematoma,edema,infection,delayed heal,scarring,and contraction of incision.The appearance is no different from original.Follow-up 6-12 months,sexual intercourse is satisfaction and no special complication.【Conclusion】 The procedure compared with the conventional circumcision is effective,simple procedure and very few complications.