保留皮下神经血管网的改良袖套式包皮环切术治疗包皮过长及包茎

Modified Sleeve Type with Preservation of Subcutaneous Nerves and Blood Vessels Network Circumcision for the Treatment of Redundant Prepuce and Phimosis

目的:探讨保留阴茎皮下神经血管网的改良袖套式包皮环切术在治疗包皮过长及包茎中的临床效果。方法:选取2020年6月-2022年5月于笔者医院就诊的46例男性包皮过长或包茎患者作为研究对象,所有患者行保留阴茎皮下神经血管网的改良袖套式包皮环切术,统计患者手术时长、术中出血情况、术后疼痛持续时间、术后外观、术后并发症发生情况及患者满意度。结果:46例患者均顺利完成手术,手术时长(48.62±7.54)min,术中出血量(5.53±3.56)ml,术中疼痛评分(1.60±0.62)分,创口愈合时间(14.56±2.51)d,术后发生局部肿胀1例、伤口感染1例,总并发症发生率为4.35%。患者术后缝合线全部自行脱落,术后疼痛时间较短(18.32±7.24)h,切口愈合良好,切缘外表美观。术后随访1~6个月,患者对手术效果的满意度为95.65%。结论:保留皮下神经血管网的改良袖套式包皮环切术具有术中出血少、术后恢复快、疼痛轻、并发症发生率低、术后阴茎形态良好等优点,患者满意率高,值得临床推广应用。

Objective To explore the surgical method and clinical effect of the modified sleeve circumcision preserving the subcutaneous neurovascular network of the penis in the treatment of redundant prepuce and phimosis.Methods A total of 46 male patients with redundant prepuce or phimosis who were treated in the author's hospital from June 2020 to May 2022 were selected as the research objects.All patients underwent modified sleeve circumcision with preservation of penile subcutaneous neurovascular network.The operation time,intraoperative bleeding,postoperative pain duration,postoperative appearance,postoperative complications,and patient satisfaction were recorded.Results All 46 patients successfully completed the operation.The operation time was(48.62±7.54)min,the intraoperative blood loss was(5.53±3.56)ml,the intraoperative pain score was(1.60±0.62),and the wound healing time was(14.56±2.51)d.There was 1 case of local swelling and 1 case of wound infection after operation.The overall complication rate was 4.35%.All the sutures fell off spontaneously,the postoperative pain time was shorter(18.32±7.24)h,the incision healed well,and the appearance of the incision margin was beautiful.The patients were followed up for 1 to 6 months,and the patient's satisfaction with the surgical effect was 95.65%.Conclusion The modified sleeve circumcision preserving the subcutaneous neurovascular network has the advantages of less bleeding during operation,rapid recovery after operation,light pain,low complication rate,good penis shape after operation,inconspicuous scar,and definite curative effect,which is worthy of clinical application.