免白膜缝合两点固定法治疗小儿隐匿性阴茎（附38例报道）

A novel cavernosum-free surgical technique for concealed penis of children

目的探讨在免白膜缝合两点固定法治疗小儿隐匿性阴茎的可行性与适用性。方法2017年6～8月收治38例隐匿性阴茎患儿，年龄4～13岁，平均8．5岁。患儿均行手术治疗，术中在阴茎2点及10点位置将阴茎根部皮肤真皮层固定于相对应的腹股沟韧带内侧脚上，术中不行阴茎白膜固定。结果患儿手术结束2～6h后均能自行排尿，术后疼痛数字评分法评分1～3分，5～7d拆除纱布，切口均一期愈合，阴茎伸直良好，包皮自然翻起，阴茎头外露。所有病例术后阴茎显露长度较术前平均增加3cm。其中术后发生切口水肿3例，在术后5～7d均消退；术后未发生切口出血、阴茎偏曲等并发症。结论免白膜缝合两点固定法治疗小儿隐匿性阴茎效果显著，操作简单，是一种治疗隐匿性阴茎的较好术式。

Objective To explore the feasibility and applicability of a novel cavernosum-free surgical technique for concealed penis of children. Methods From June 2017 to August 2017, 38 boys with concealed penis were treated using our new cavernosum-free surgical technique. The median age was 8.5 years（4 - 13 years）. The technique consisted of 3 steps： Step 1 , making a horizon incision and expose the glans ; Step 2, suturing skin of penis to the corresponding side of inguinal ligament medial crus at 2 and 10 o＇clock without fixing of cavernosum. Step 3, pruning the foreskin and suturing together. No catheter was placed after surgery. Results All the patients were able to urinate 2 to 6 hours after operation. The numeric rating scales score of postoperative pain was 1 - 3. Wound dressing was removed 5 to 7 days postoperatively. All of the parents had good cosmetic appearance, penis stretched naturally without deflection. The length of penis increased more than 3.0 cm on average after operation. Edema was observed in 3 cases, but disappeared in 5 - 7 days. No serious complications such as bleeding or winding occurs. Conclusions The novel cavernosum-free surgical technique is easy to perform. It provides a safe and effective technique for concealed penis of children.