改良套袖式包皮环切术治疗包皮过长及包茎

目的 探讨改良套袖式包皮环切术治疗包皮过长或包茎患者的疗效.方法 采用改良套袖式包皮环切术治疗包皮过长患者58例.术中先标记包皮切除长度,在直视下于包皮内、外板做两个互相平行的环形切口,将两切口间包皮条用小圆头刀锐性剥离,保留完整肉膜及皮下浅层血管和完整的包皮系带.结果 58例患者术中出血极少.切口整齐,术后切口无水肿、继发性出血、感染等发生,切口均Ⅰ期愈合,瘢痕少,阴茎外形美观.结论 改良套袖式包皮环切术治疗包皮过长,术后并发症少,外形美观,疗效确切.     

脱袖式包皮整形环切术

目的探讨脱袖式包皮整形环切术治疗包皮过长及包茎的方法和效果。方法采用脱袖式包皮整形环切术治疗包皮过长及包茎患者87例。取包皮横行切口环形切开,于浅筋膜层次分离达到阴茎根部,环形切除多余皮肤。结果患者术中出血少,术后伤口水肿轻,恢复快,愈合后切口外形美观。结论脱袖式包皮整形环切术对包皮过长及包茎患者治疗效果满意。     

改良袖套式包皮环切术治疗包皮过长及包茎

目的：探讨改良袖套式包皮环切术治疗包皮过长及包茎患者的方法和效果。方法：采用改良袖套式包皮环切术治疗包皮过长及包茎患者65例。术中先标志包皮切除长度，在直视睛于包皮内、外板作两个互相平行的环形切口，将两切口间包皮条用小圆头刀锐性剥离，保留完整肉膜及皮下浅层血管，并保留完整的包皮系带。结果：65例术中出血极少，切口整齐，术后伤口无水肿，无继发性出血及感染，均一期愈合，切口瘢痕少，阴茎外形美观。结论：改良袖套式包皮环切术对包皮过长及包茎患者治疗效果满意。     

包皮内板环切术治疗包茎及包皮过长的临床应用

目的 探讨应用包皮内板环切术治疗包茎及包皮过长的方法和效果.方法 52例包皮过长及包茎患者,均用亚甲蓝标记切口线.对单纯包皮过长的患者,采用包皮内板环切术治疗;包茎患者须同时结合阴茎背侧及腹侧包皮纵行切开松解术.结果 52例患者术后均无明显水肿、出血、切口感染等并发症,术后7d拆线,切口Ⅰ期愈合.随访3～6个月,阴茎及包皮外形均满意,无系带感觉障碍等.结论 应用包皮内板环切术治疗包茎及包皮过长的方法,不会切除过多的包皮,操作方法简单、安全,术后水肿较轻,出血少,可获得较满意的临床效果.     

电切法袖套式包皮环切术200例临床分析

目的:探讨电切法袖套式包皮环切术治疗包皮过长与包茎患者的安全性与疗效。方法:采用电切法袖套式包皮环切术治疗包皮过长与包茎患者200例,分析手术效果、并发症及其预防措施。结果:200例电切法袖套式包皮环切术出血少、切缘整齐,术后包皮水肿轻微,切口均一期愈合,瘢痕少,阴茎外观满意。结论:电切法袖套式包皮环切术治疗包皮过长与包茎患者效果满意,并发症少,值得临床推广。     

阴茎根部包皮袖套状环切术与传统包皮环切术的疗效比较

包皮过长和包茎是泌尿外科门诊常见病、多发病.目前治疗包皮过长、包茎的方法有许多种,如袖套式包皮环切术、背侧剪开包皮环切术(传统包皮环切术)、血管钳夹包皮环切术、激光包皮环切术及器械环扎术等.我们对包皮过长、包茎患者156例分两组进行手术,一组采用阴茎根部包皮袖套状环切术,另一组采用传统包皮环切术,比较两组手术的疗效,现报告如下.     

内板切除系带延长改良包皮环切术283例临床报告

目的探讨内板切除系带延长改良包皮环切术治疗包皮过长及包茎患者的方法和效果。方法采用内板切除系带延长改良包皮环切术治疗包皮过长及包茎患者283例。术中按阴茎勃起时的长度确定切除包皮多少,上推外板止血后,游离内板上包含大量淋巴管的皮下组织并保留。切除内板,纵行缝合系带止血并向下延长1-1.5cm,常规缝闭内外板切缘。培杲283例术后切口整齐,均I期愈合,无1例出现并发症,外形美观。结论内板切除系带延长改良包皮环切术治疗包茎及包皮过长疗效满意.优于传统手术。     

包皮环扎术与包皮环切术治疗小儿包茎、包皮过长疗效分析

目的分析应用包皮环扎术与环切术治疗小儿包皮过长、包茎临床效果。方法将200例小儿包茎、包皮过长随机分为包皮环扎组90例、环切组110例,随访6～12个月,评价疗效。结果包皮包皮环扎组手术时间明显少于包皮环切组,但切口愈合时间及术后并发症发生率明显高于包皮环切组,差异有统计学意义(P相似文献   

改良式商环包皮环切术的临床疗效观察

目的探讨改良式商环包皮环切术的临床效果。方法在距离阴茎冠状沟0．8cm处放置商环内环,回翻包皮后放置外环,将外环与内环锁住后切除多余包皮。结果本组共35例患者,术后切口裂开1例,轻度水肿8例;无切口感染及术后继发出血。切口均I期愈合,平均手术时间为7min。随访1～6个月,切口瘢痕不明显,排尿及阴茎勃起正常,外观效果满意。结论采用改良式商环包皮环切术治疗包茎和包皮过长,是理想的手术方法,值得临床推广应用。     

一次性包皮环切吻合器行包皮环切术120例体会

目的观察一次性包皮环切吻合器治疗包茎、包皮过长的效果。方法对120例包茎、包皮过长患者采用一次性包皮环切吻合器治疗,回顾分析患者的的临床资料。结果 7～10 d下环,有5例术后第4～5 d因夜间阴茎勃起,未处理,出现少许包皮脱出环外,切口裂开,致切口延期愈合。其余115例患者切口愈合良好,术后阴茎外形美观。结论该方法手术时间短,微创、无需缝合、患者痛苦少、便捷,效果肯定,值得推广。     

209例不同术式环切术治疗包茎和包皮过长

目的评价不同术式环切术治疗包茎及包皮过长的方法和疗效。方法自2001年起,共收治包茎和包皮过长患者209例,包茎85例,包皮过长124例。其中已婚者53例。行剪刀法包皮环切术59例,血管钳法包皮环切术31例,袖套法包皮环切术47例,阴茎根部皮肤环切术72例。结果改良术式(袖套法、根部法)手术时间、术中出血量和术后创口疼痛时间与传统术式(剪刀法、血管钳法)比较差异均有统计学意义(P<0.01)。传统术式发生出血或血肿19例,伤口感染10例,阴茎水肿34例,包皮过长或过短8例;改良术式术后伤口感染2例,阴茎水肿5例,无出血或血肿及包皮过长或过短。总并发症发生率为37.32%,其中传统术式并发症33.97%,改良术式3.35%,对比差异有显著性意义(P<0.01);已婚者性满意度提高23例,其中改良术式18例,差异有统计学意义(P<0.05)。结论严格掌握不同术式的适应证,根据患者情况灵活选择术式可降低并发症发生率,提高婚后性生活质量。     

3种包皮环切术的临床疗效分析

目的:比较传统包皮环切术、袖套状包皮切除术和包皮环切吻合术治疗包皮过长或包茎患者的临床疗效。方法:回顾性分析我院泌尿外科门诊采用传统包皮环切术(n=279)、袖套状包皮切除术(n=354)和包皮环切吻合术(n=285)治疗包茎或包皮过长918例患者的临床资料,比较3种术式手术时间、术中出血量、手术者对手术的满意度、术后4 h和7 d视觉模拟疼痛评分、术后并发症、创口完全愈合时间、包皮水肿程度、患者对术后外观的满意程度及围手术期费用等指标。结果:包皮环切吻合术在手术时间和术中出血量等方面要优于袖套状包皮切除术和传统包皮环切术(P<0.05)。传统包皮环切术、袖套状包皮切除术和包皮环切吻合术的创口完全愈合时间分别为(18.6±5.2)d、(11.4±3.7)d、(20.3±5.7)d,表明袖套状包皮切除术创口完全愈合时间明显优于传统包皮环切术和包皮环切吻合术(P<0.05)。袖套状包皮切除术在手术者对手术的满意度、术后水肿程度、术后并发症以及患者对外观的满意度等方面与包皮环切吻合术相似,但要优于传统包皮环切术(P<0.05)。传统包皮环切术和袖套状包皮切除术在术后7 d视觉疼痛模拟评分和围手术期费用上明显低于包皮环切吻合术(P<0.05)。结论:3种术式各有优缺点,最终的术式选择需根据患者的年龄、经济承受能力和手术者对不同术式的手术技巧差异和熟悉程度等多方面来考虑。     

Lateral preputioplasty for phimosis.

There exists a lack of understanding of normal preputial development which is reflected in the large numbers of inappropriate referrals for circumcision. While the scarred prepuce invariably responds best to formal circumcision a more conservative approach is recommended in those symptomatic patients with non-retractile foreskins. In this study, patients referred to the out-patient department with a phimosis were assessed. Those with a phimosis and secondary preputial scarring were listed for circumcision. Those with a narrowed foreskin and a history of recurrent balanitis or local symptoms such as fissuration, thought suitable for a more conservative approach, were listed for preputioplasty. Those with a phimosis but without local symptoms were reassured and discharged. Thirty patients were referred for preputioplasty. One patient developed a post-operative wound infection which settled with oral antibiotics prescribed by his general practitioner. This left him with further preputial adhesions and he later underwent circumcision. The remaining patients reported no post-operative problems at follow-up. Cosmesis was good with high levels of patient satisfaction expressed. All had easily retractile foreskins at follow-up. Large numbers of patients might reasonably benefit from a lateral preputioplasty when presenting with a symptomatic phimosis in the absence of significant scarring of the prepuce. It avoids the needless loss of the foreskin, the importance of which is only now beginning to emerge.     

应用商环治疗儿童包皮过长和包茎的体会

目的:总结应用商环在儿童包茎及包皮过长治疗中的经验。方法:对2008~2010年551例儿童包茎、包皮过长手术(商环组342例,传统环切组209例)进行回顾性分析。结果:与传统环切相比,商环具有手术时间短(P<0.05)、不需包扎、切口工整等优点,但也具有伤口愈合时间长(P<0.05)、疼痛更明显等缺点(P<0.05)。结论:儿童包皮过长、包茎手术,应用商环与传统手术比较二者各有优缺点,但是商环优点更明显、更可行。     

商环在包皮环切术中的临床应用

目的探讨商环包皮环切术治疗包皮过长、包茎的效果。方法应用商环对240例患者(包皮过长208例,包茎32例)行包皮环切术,观察患者术后恢复情况。结果本组240例,均行阴茎根部背神经阻滞麻醉,手术时间为10~15 min,术后均无出血、无商环断裂。术后轻微疼痛48例,明显疼痛8例。水肿64例,其中严重水肿1例。下环后未发生切口裂开和感染。随诊1个月,阴茎外形满意,包皮切缘平整,无狭窄环形成。结论商环行包皮环切术具有良好的临床效果,值得临床推广应用。     

Save the foreskin: Outcomes of preputioplasty in the treatment of childhood phimosis

BackgroundSymptomatic phimosis is a common childhood urology complaint. Circumcision was traditionally the treatment of choice, but its popularity in cases of non-scarred phimosis has been superseded by more conservative methods like preputioplasty. We sought to examine outcomes of preputioplasty for the treatment of non-scarred pathological phimosis in two UK paediatric surgery tertiary centres.MethodsRetrospective case series selecting cases performed in both departments over a 4 year period (January 2012–December 2015). Inclusion criteria: non-scarred pathological phimosis treated with preputioplasty. Exclusion criteria: diffuse scarring of foreskin or presence of balanitis xerotica obliterans (BXO), preputioplasty performed as part of hypospadias repair. Outcome measure was treatment success as evidenced by fully retractile prepuce at follow up. Follow up occurred between 3 and 24 months.ResultsWe identified 126 patients, 6 were excluded due to the above criteria. Median age was 13.4 years (range 10 months–18 years). Median follow up was 13 months (range 3–24 months). 115 patients (96%) had successful treatment as evidenced by satisfactory post-operative cosmesis and complete resolution of phimosis at follow up. Recurrence of phimosis occurred in 5 patients (4%). Mean time of recurrence was 6 months, with a median age of recurrence of 15.3 years (range 10.7–16.7 years). All patients with recurrence were successfully treated with circumcision.ConclusionForeskin conserving methods like preputioplasty are a valid option in the treatment of non-scarred pathological phimosis.     

用包皮去除环进行成人包皮环切术

目的探讨用一种新器械-包皮去除环进行包皮环切术的方法和效果。方法对2组各100例患者分别施行该手术和经典的包皮环切术,随访3～6个月,对比手术时间、手术失血,前瞻性对比术后疼痛、不适及术后失血、水肿等并发症和术后包皮形状、勃起功能。结果该术的切除范围标准,并发症少,痛苦小,患者的满意度高。结论用该器械进行包皮环切术是一种新的有效的包皮环切方法。     

新型一次性包皮环切吻合器治疗包皮过长和包茎2O例临床分析

目的：探讨新型一次性包皮环切吻合器治疗包皮过长和包茎的治疗效果。方法：应用一次性包皮环切吻合器,对20例包皮过长或包茎的患者,给予包皮环切术。结果：手术均采用包皮环切吻合器完成。手术时间平均约3～8min。术后未出现切口大片裂开,血肿形成或迟发大量出血。其中2例患者有少量渗血,行加压包扎两天后出血完全停止,1例有钛钉松动伴有约1．5cm切口裂开,予换药包扎5天后切缘对合平整,余下患者3天后拆除纱布无明显水肿、出血。术后1个月复诊,20例患者切口愈合良好,术后阴茎外观美观。结论：新型一次性包皮环切吻合器切割吻合一次完成,微创、手术时间短,患者痛苦小,美观、治疗效果好,值得推广。