经耻骨上“Ω”形切口脂肪切除术在成人肥胖型隐匿性阴茎患者阴茎矫正术中的应用

Suprapubic lipectomy with a "Ω" incision for buried penis in obese adult men

目的:探讨经耻骨上"Ω"形切口祛除耻骨前脂肪垫在成人肥胖型隐匿性阴茎矫形术中的应用。方法:回顾性分析上海交通大学医学院附属第九人民医院泌尿外科2016年8月至2019年9月采用耻骨上"Ω"形切口祛除耻骨前脂肪垫联合反向脱套松懈阴茎肉膜纤维索带并阴茎根部固定术治疗20例成人肥胖型隐匿性阴茎患者的临床资料。结果:所有患者均手术成功,住院时间(8.3±3.3) d;手术时间为(3.7±0.6) h。1例术后脂肪液化致切口感染、切口延迟愈合,经积极抗感染、换药处理后痊愈,所有病例均未发生大出血、脂肪栓塞等严重并发症。所有患者随访3个月,阴茎外露满意,患者对阴茎及耻骨上切口外形满意度95%,无阴茎勃起功能障碍、阴茎头感觉异常、阴茎回缩等术后并发症发生。结论:耻骨上"Ω"形切口祛除耻骨前脂肪垫,同时反向脱套松懈阴茎肉膜纤维索带及阴茎根部固定,从解剖学角度彻底矫正成人肥胖型隐匿性阴茎,安全有效,并发症低,值得进一步研究和推广。

Objective: To investigate the application of suprapubic lipectomy with a "Ω" incision to removal of the prepubic fat pad for the management of buried penis in obese adult patients. Methods: We retrospectively analyzed the clinical data on 20 obese adult patients with buried penis treated by suprapubic lipectomy via a "Ω" incision between August 2016 and September 2019. Results: The operations were successfully completed in all the cases, with a mean operation time of 3.7 ± 0.6 hours and an average hospital stay of 8.3 ± 3.3 days. There were no such severe surgery-related complications as hematoma, urethral injury, or fat embolism in any of the cases. Fat liquefaction-related superficial wound infection developed in 1 patient postoperatively, which was cured by combined topical and systemic antibiotic therapy. A 3-month follow-up showed a 95% satisfaction of the patients with the postoperative appearance of the penis and suprapubic incision, but no complications such as ED, abnormal penile sensation, or penile retraction. Conclusion: Suprapubic lipectomy with a "Ω" incision to remove the prepubic fat pad is an effective surgical approach to the management of buried penis in obese adult males, which is an anatomy-based surgical correction and has the advantages of slight injury, rapid recovery and few complications.