儿童隐匿性阴茎合并有外生殖器其他畸形的治疗体会

Experience in the treatment of hidden penis combined with otherabnormalities of external genitalia in children

目的探讨儿童隐匿性阴茎同时合并外生殖器其他畸形时的治疗方法。方法回顾性分析2019年5月至2021年8月该院收治的60例先天性隐匿性阴茎的患儿的资料,总结治疗方案。结果发现隐匿性阴茎合并阴茎上弯4例,阴茎下弯1例,尿道下裂1例,尿道口囊肿2例,干燥闭塞性阴茎头炎(BXO)2例。4例(6.7%)阴茎上弯的患儿予以阴茎腹侧间断缝合紧缩以矫直阴茎。1例(1.7%)阴茎下弯患儿予以阴茎背侧间断缝合固定以矫直阴茎,至勃起试验外观满意。1例(1.7%)尿道下裂的患儿为冠状沟型尿道下裂,行尿道成形术。2例(3.3%)尿道口囊肿的患儿同期行尿道口囊肿剔除术,术后病检结果符合诊断。2例(3.3%)BXO患儿切除瘢痕组织,保留更少的内板组织,术后病检符合诊断。所有病例术后均恢复较好,门诊随访未见明显并发症,患儿家长满意度可。结论在隐匿性阴茎手术中发现合并其他畸形时,建议同期手术处理,减少患儿因二次手术带来的损害。

Objective To explore the treatment method for children with hidden penis combined with other abnormalities of external genitalia.Methods The data of 60 children with congenital occult penis admitted to our hospital from May 2019 to August 2021 were retrospectively analyzed,and the treatment plan was summarized.Results There were 4 cases of occulted penis complicated with superior penile curvature,1 case with inferior penile curvature,1 case with hypospadias,2 cases with urethral meatus cyst and 2 cases with balanitis xerotica obliterans(BXO).In 4 cases(6.7%)with upward curvature of the penis,intermittent suture tightening was performed on the ventral side of the penis to straighten the penis.In 1 case(1.7%)of children with penile curvature,the dorsal side of the penis was fixed with interrupted sutures to straighten the penis until the appearance of the erection test was satisfactory.One case(1.7%)with hypospadias was coronal type hypospadias and underwent urethroplasty.Two cases(3.3%)with urethral orifice cyst underwent urethral orifice cyst excision at the same time,and the postoperative pathological examination results were consistent with the diagnosis.In 2 cases(3.3%)with BXO,cured by resecting the scar tissue and retaining less inner plate tissue,and the postoperative pathological examination was consistent with the diagnosis all cases recovered well after operation,no obvious complications were found in outpatient follow-up,and the parents of the children were satisfied.Conclusion For the combined deformity found in the concealed penis surgery,it is recommended to deal with it at the same time to reduce the damage caused by the second surgery.