阴茎悬吊系统在隐匿性阴茎矫治手术中的解剖应用(附56例报道)

Anatomical application of penile suspension system in occult penile correction surgery(report of 56 cases)

目的探讨研究阴茎悬吊系统作为解剖标记在隐匿性阴茎矫治手术中的临床应用。方法回顾性分析2019年7月至2021年12月在本院经手术治疗的56例隐匿性阴茎患者的临床资料, 所有患者均实施隐匿性阴茎矫治手术, 术中利用阴茎悬吊系统作为解剖标记, 将阴茎皮肤逆向脱套至阴茎体根部背侧正中的阴茎悬韧带及呈"U"型包绕阴茎根部的袢状韧带, 切断阴茎悬韧带浅部, 从而充分释放阴茎海绵体, 然后以袢状韧带作为水平标记线, 于阴茎体根部1点和11点处将阴茎白膜缝合固定于耻骨联合前部皮肤的真皮层, 以重建阴茎-腹壁角进一步改善阴茎显露效果, 术中注意保护袢状韧带、阴茎悬韧带深部及耻骨弓状韧带, 保障阴茎术后勃起的稳定性和勃起角度。结果所有患者均顺利完成手术, 手术时间为(78.0±6.5)min, 术前疲软状态时的阴茎长度为(2.2±0.6)cm, 术后1个月复查疲软状态时的阴茎长度为(5.6±0.4)cm, 患者术后阴茎长度较术前增加(P<0.05), 所有患者均对术后阴茎外观显露非常满意, 阴茎勃起时与腹壁夹角均<90 °, 且可稳定维持勃起角度和方向;对48例已有性生活的成年患者分别于术前、术后3个月进行性关系和自信心评估量表(SEAR)测评, 结果显示, 患者术前的SEAR评分为(31±4)分, 术后3个月的SEAR评分为(60±5)分, 差异有统计学意义(P<0.05)。结论利用阴茎悬吊系统作为隐匿性阴茎矫治手术过程中的解剖标记, 不仅有助于临床医生从解剖角度更科学地诊治隐匿性阴茎, 而且有利于规范化隐匿性阴茎矫治手术步骤, 手术安全、有效, 患者术后满意度高, 值得临床推广应用。

Objective To evaluate the clinical application of penile suspension system as anatomical markers during the plastic surgery of concealed penis.Methods A retrospective analysis was made on 56 patients with concealed penis received plastic surgery in our hospital from July 2019 to December 2021.Concealed penile corrective surgery was performed in all patients.During the operation,the penile suspension system was used as an anatomic marker,and the penile skin was removed to the penile suspension ligament in the dorsal center of the penile root and the loop ligament wrapped around the penile root in a"U"shape,and the superficial part of the penile suspension ligament was cut to fully release the penile corpus cavernosum,and then the loop ligament was used as the horizontal marker line.The white membrane of the penis was sutured and fixed in the dermis of the skin of the anterior symphysis pubis at 1 and 1l points at the root of the penis body,so as to reconstruct the penisabdominal angle and further improve the penis exposure effect.During the operation,attention was paid to protecting the ansa ligament,the deep suspensory ligament of the penis and the arcuate ligament of the pubis,so as to ensure the stability and erection Angle of the penis after operation.Results The operation time was(78.0±6.5)min.The length of penis in weak state before surgery was(2.2±0.6)cm,and the length of penis in weak state was(5.6±0.4)cm after 1 month.The average postoperative penis length increased(P<0.05).All patients were very satisfied with the appearance of the penis after operation,and the angle between the penis and the abdominal wall was less than 90°,and the angle and direction of erection could be maintained stably.Sexual Relationship and Self-Confidence Assessment Scale(SEAR)was performed on 48 adult patients with sexual intercourse before and 3 months after surgery,respectively.SEAR score was(31±4)scores before surgery and(60±5)scores after 3 months(P<0.05).Conclusions The use of penile suspension system as an anatomical marker during occult penile correction surgery is not only helpful for clinicians to diagnose occult penile diseases more scientifically from an anatomical point of view,but also conducive to the standardization of occult penile correction surgery procedures.The operation is safe,effective,and the patients have high postoperative satisfaction,which is worthy of clinical promotion and application.