隐匿阴茎改良手术的疗效与安全性观察

Efficacy and Safety of a Modified Surgery for Concealed Penis

目的探讨一种改良手术治疗隐匿阴茎的疗效和安全性。方法自2007年1月至2018年9月,共收治了隐匿阴茎患儿100例,按照时间界限随机分成2组,2组分别行传统手术(Devine术)和改良手术,比较2种手术方法的手术时间、出血量、治疗效果(外观、阴茎发育情况、患者满意度)、并发症等差异。结果所有患者在一般情况、BMI (Body mass index)等方面无统计学差异。传统组术前阴茎长度(1.93±0.73) cm,术后阴茎长度(4.02±1.07) cm,差异有统计学意义(P <0.001);改良组术前阴茎长度(1.96±0.55) cm,术后阴茎长度(3.84±0.76) cm,差异有统计学意义(P <0.001)。2组术前及术后阴茎长度对比差异无统计学意义(术前:P=0.780,术后P=0.333)。传统组手术时间(67.16±4.24) min,改良组手术时间(43.90±3.01) min,2组对比差异有统计学意义(P <0.001)。传统组手术出血量(10.56±2.60) mL,改良组出血量(5.32±1.61) mL,2组对比差异有统计学意义(P <0.001)。所有病例均随访3~120个月,改良组全部病例阴茎均外观满意,发育正常,12例病例术后出现包皮水肿,其中10例逐渐消退,2例行包皮水肿切除术后恢复,未出现严重并发症。传统组45例外观满意,阴茎发育正常;并发症方面,有30例出现包皮水肿,随着恢复消退;8例出现术后阴茎根部剧烈疼痛,对症治疗后好转;5例对于阴茎外观不满行二次手术,发育正常。结论本改良手术步骤简单,术中出血少,术后阴茎矫形良好,患者及家属长期满意度高,是治疗隐匿阴茎的一种有效术式。

Objective To investigate the efficacy and safety of a modified surgery for concealed penis.Methods From January 2007 to September 2018, we treated 100 children with concealed penis and randomly divided them into two groups according to the time limit. One group had been treated with conventional surgery(Devine method) and the other one treated with the modified surgery. We analyzed the difference of the operation time, bleeding amount, treatment effect(appearance, penis development, patient satisfaction) and complications between the two groups. Results There were no statistical difference in general conditions and BMI between the two groups. In the traditional group, the length of the penis was(1.93±0.73) cm before the operation and(4.02±1.07) cm after the operation. The difference was statistically significant(P < 0.001). In the modified group, the length of the penis was(1.96±0.55) cm before the operation and(3.84 ± 0.76) cm after the operation, the difference was statistically significant(P < 0.001). There was no significant difference in the length of penis between the two groups before and after surgery(preoperative: P = 0.780, postoperative P = 0.333). The operation time of the traditional group was(67.16±4.24) min, and the modified group was(43.90±3.01)min. The difference between the two groups was statistically significant(P < 0.001). The amount of bleeding in the traditional group was(10.56±2.60) ml and in the modified group was(5.32±1.61) ml. The difference between the two groups was statistically significant. All cases were followed up for 3 months to 120 months. In all the modified cases, the appearance of the penis was satisfactory and the development was normal, and none was suffered from serious complications. Foreskin edema appeared in 12 cases, 10 of them was subsided gradually, and 2 cases recovered after foreskin edema resection. In the traditional group, 45 patients had satisfactory appearance and normal penis development. In terms of complications, there were 30 cases of foreskin edema, which recovered with the recovery, 8 cases had severe pain in the root of the penis after surgery, and improved after treatment, 5 cases were dissatisfied with the appearance of the penis and suffer the second surgery, but the development of penis was normal. Conclusion This modified surgery is simple to master and the bleeding is less, the effect is good,patients and their families have high long-term satisfaction. The method is effective and safe for the treatment of concealed penis.