经阴茎腹侧根部入路及应用包皮环治疗隐匿阴茎

A new treatment of concealed penis through the ventral penile root and circumcision

目的研究经阴茎腹侧根部入路及应用包皮环切术治疗先天性隐匿性阴茎的临床疗效。方法此种手术方式主要针对阴茎海绵体发育正常的隐匿性阴茎并伴有包茎的患者,采用经阴茎腹侧根部梭形切开不仅可以充分松解、固定阴茎,而且切口小有利于术后愈合及减少并发症的发生。与此同时,通过调整包皮环放置的深度及倾斜角度进行的包皮环切术还解决了包茎及内板多外板少的问题。结果经统计我科近4年来用此种手术方式共治疗隐匿性阴茎患者135例,年龄最小2岁,最大16岁,平均年龄6.6岁,135例患者均获得半年以上追踪随访,其中134例患者术后阴茎显露良好,阴茎及包皮长度满意,无切口感染、无阴囊渗血血肿、无排尿困难、无痛性勃起、无继发性包茎、无阴茎阴囊水肿、无阴茎回缩、无反复发作的包皮龟头炎及包皮环阴囊处切口瘢痕愈合,仅1例患者出现术后远期包皮环瘢痕愈合形成狭窄,经门诊给予瘢痕切除后治愈。结论此种治疗隐匿性阴茎的术式是一种简单有效,治疗效果显著,术后并发症少的新型手术方式。

Objective To explore the clinical effect of concealed penis by using a new technique,in which the way is through the ventral of the penis root and circumcision. Methods This operation was mainly for the patients of the concealed penis with the normal penis and the varying degrees of the phimosis. The technique involved the creation of a wedge-shaped cut of the ventral penile skin,which not only fix the subcutaneous penile skin at the base of the degloved penis to the buck fascia,but also reduced the complications. The pierced ring was effective in the dorsal inner preputial skin obliquely and in postoperative fixation. Results We reported a retrospective review of the 135 patients(median age： 6. 6 years） who underwent buried penis repair in the last 4 years(age between 2 to 16 years）. All patients after repair were followed for an average of 6 months. 134 patients had a cosmetically pleasing result without wound infections,hematoma of scrotum,trapped penis,recurrent balanitis,differenty voiding and secondary phimosis. Only one patient had a trapped penis with a ring of the scar tissue,which required subsequent excision. Conclusion The operation treatment is a simple and effective approach with less complications.