青春期前隐匿性阴茎肉膜组织病理学分析及临床意义

Sarcolemma tissue of prepubertal concealed penis: Pathological characterization and clinical implication

目的:评估青春期前隐匿性阴茎肉膜组织病理学特点及其临床意义。方法:10例青春期前隐匿性阴茎患儿作治疗组,予以改良Devine术治疗。10例正常青春期前儿童作对照组,予以包皮环切术治疗。分别于术前行阴茎长度测量;通过术中解剖学观察,以及用Masson三色染色法检测阴茎肉膜组织纤维化程度。结果:治疗组患儿术前阴茎长度为(1.49±0.17)cm,较对照组[(4.26±0.23)cm]明显短(P<0.01)。术中发现阴茎的隐匿程度与其阴茎肉膜纤维条索状组织远端附着部位有关,其远端附着点越靠近冠状沟,阴茎的隐匿程度越严重。Masson三色染色示治疗组阴茎肉膜组织胶原纤维阳性面积比为(65.6±6.9)%,明显高于对照组的(37.1±4.7)%(P<0.01)。结论:隐匿性阴茎的肉膜组织明显呈纤维化改变,其手术关键是彻底切除纤维化的阴茎肉膜组织。

Objective： To evaluate the histopathological characteristics and clinical implication of sarcolemma tissue in prepubertal concealed penis. Methods： After measurement of the penile length, 10 prepubertal children with congenital concealed penis underwent modified Devine operation （treatment group）, and another 10 normal prepubertal children received circumcision （control group）. The anatomic features of the penile sarcolemma tissue was observed intraoperatively, and its fibrosis was evaluated by Masson trichrome staining. Results： The penile length of the treatment group was significantly shorter than that of the control group preoperatively （ [ 1.49 ± 0.17 ] cm vs [ 4.26 ± 0.23 ] cm, P 〈 0.01 ）. The degree of penile concealment was correlated with the distal point of the attachment of its sarcolemma fibrous tissue ： the closer the distal attachment point was to the coronary ditch, the more serious was penile concealment. The proportion of the area of collagen fibers in the penile sarcolemma tissue was significantly higher in the treat- ment group thanin the control （[65.6±6.9]% vs [37.1 ±4.71%, P〈0.01）. Conclusion： Sarcolemmafibrosis was obvious in congenital concealed penis, and the key to its management is drastic removal of all the fibrous sarcolemma tissue. Natl J Androl, 2013, 19 （3） ： 228 -231