保守方法改良后治疗闭合性阴茎白膜破裂的疗效评价

Efficacy of the improved conservative method in the treatment of penile fracture

目的探讨保守方法改良后治疗闭合性阴茎白膜破裂的疗效。方法回顾性总结分析2002年2月至2016年3月海南省人民医院收治的75例闭合性阴茎白膜破裂患者的临床及随访资料,并根据治疗方式分为保守组(23例)及手术组(52例)。结果性交不当是主要致伤因素(62.7%)。白膜裂口主要位于阴茎后半段(77.3%),裂口长度在保守组及手术组分别为(4.5±2.5)mm及(16.7±7.7)mm,差异有统计学意义(P<0.001)。阴茎海绵体增厚/硬结的远期发生率比较,保守组比手术组高,差异有统计学意义(P=0.020)。在保守组去除裂口位于根部的患者情况下,手术组及保守组的并发症发生率分别为25.0%及33.3%,差异无统计学意义(P=0.706)。结论对于闭合性阴茎白膜破裂,手术修复仍为标准治疗。留置尿管下全阴茎弹力绷带加压包扎对于位置合适且损伤不重的患者可考虑使用。

Objective To evaluate the efficacy of the improved conservative method in the treatment of penile fracture. Methods The clinical data and follow-up outcomes of 75 patients with penile fracture who admitted to our hospital from February 2002 to March 2016 were retrospectively reviewed. These patients were divided into the conservative group（n=23） and the surgical group（n=52） according to treatment methods. Results Improper sexual intercourse was the main injury factors, accouning for 62.7%. The tunical defects was mainly located at the proximal half part of penis with 77.3%, and the mean length in the surgical group was（4.5±2.5） mm, which was significantly shorter than（16.7 ± 7.7） mm in the conservative group（P〈0.001）. Penile thickening/nodule was the most common long-term complications, and the complications in the conservative group were significantly higher than those in the conservative group（P=0.020）. Under the condition of the patients with tunical defects located at the bottom of penis were excluded,the true complication incidences in the conservative group and the surgical group were respectively 33.3% and 25.0%（P=0.706）. Conclusion For the patients with penile fracture, surgical repair is still the standard treatment. Elastic bandage compression with catheter is suitable for some mild patients.