脱细胞真皮基质填充耻骨下间隙应用于成人隐匿性阴茎治疗的效果观察

Therapeutic effect of acellular dermal matrix filled in infrapubic space for the treatment of adult concealed penis

目的探讨脱细胞真皮基质填充耻骨下间隙结合吸脂术、阴茎悬韧带松解术治疗隐匿性阴茎的效果。方法回顾性分析北京大学人民医院泌尿外科、北京怡德医院外科2015年10月至2018年7月收治的15例成年隐匿性阴茎患者的临床资料。患者年龄为(33.2±4.6)岁,体质量指数为(28.9±5.3)kg/m^(2),术前站立位非勃起状态下阴茎长度为(3.0±1.3)cm。阴茎悬韧带松解结合传统阴阜部吸脂后,应用脱细胞真皮基质填充耻骨下间隙进行治疗。观察术后阴茎长度改善及并发症发生情况,随访患者的满意度。计量资料以x±s表示,数据比较采用两样本t检验(两样本总体方差齐时)或者近似t检验(两样本总体方差不齐时)。结果术后阴茎长度为(7.3±2.1)cm,较术前增加(4.3±1.6)cm(增加143.3%);术后3个月阴茎长度为(5.4±1.8)cm,较术前增加(2.4±0.8)cm(增加80.0%),差异有统计学意义(t=13.439,P<0.05)。术后出现水肿9例(60.0%)、淤斑7例(46.7%)、血肿1例(6.7%)和包皮创口愈合不良1例(6.7%)。患者术后均无性交障碍或排尿困难。10例(66.7%)患者对术后阴茎外观和功能非常满意,4例(26.6%)满意,1例(6.7%)基本满意。结论使用脱细胞真皮基质填充耻骨下间隙结合传统阴阜吸脂术和阴茎悬韧带松解术对于治疗成年隐匿性阴茎安全有效。

Objective To investigate the effect of acellular dermal matrix filled in infrapubic space combined with liposuction and penile suspensory ligament release for the treatment of concealed penis.Methods The clinical data of 15 patients with concealed penile admitted to the Department of Urology,Peking University People’s Hospital,and Department of Surgery,Beijing Eden Hospital,from October 2015 to July 2018 were retrospectively analyzed.The age was(33.2±4.6)years,and the body mass index(BMI)was(28.9±5.3)kg/m^(2).The average length of the penises in the standing and non-erectile position was(3.0±1.3)cm.The patients were treated with acellular dermal matrix fillers combined with traditional liposuction and penile suspensory ligament release.Results The length of the penises was(7.3±2.1)cm postoperatively,which increased by(4.3±1.6)cm(143.3%increase).The length of the penises was(5.4±1.8)cm after 3 months,which increased by(2.4±0.8)cm(80%increase).Penile length was increased significantly after surgery(t=13.439,P<0.05).Postoperative complications included 9 cases of edema(60.0%),7 cases of ecchymosis(46.7%),1 case of hematoma(6.7%),and 1 case of poor foreskin wound healing(6.7%).Four patients had no complications after surgery.No patients had postoperative difficulties in sexual intercourse or urination.Most patients were subjectively satisfied with the results of surgery.Ten patients(66.7%)were very satisfied,four patients(26.6%)were satisfied,and no patients were dissatisfied with postoperative penile appearance and function.Conclusions The new method of acellular dermal matrix filled in infrapubic space combined with traditional liposuction and penile suspensory ligament release is safe and effective for penis length increase.