传统包皮环切术与包皮环切吻合术的疗效分析

目的:对传统包皮环切术与包皮环切吻合术的疗效进行分析.方法:对271例患者随机分成两组,分别采用传统包皮环切术与包皮环切吻合术,对两组的手术时间、术中出血量、术后并发症、CIEF -5进行记录,行统计学分析.结果:包皮环切吻合术组切口愈合好,外形美观,且手术时间、术中出血量明显少于传统组(P＜0.05);术后并发症发生率低于传统组(P＜0.05),性生活质量与传统组差异无显著性(P＞0.05).结论:包皮环切吻合术较传统术操作简单,疗效满意,值得推广.     

新生儿包茎及包皮过长手术治疗的研究进展

包茎及包皮过长是男性新生儿的常见病和多发病,其危害是包皮腔温暖、潮湿的环境易引起致病微生物滋生而致阴茎头包皮炎、尿路感染、肾脏疾病并影响阴茎发育等,成年后可发生阴茎癌、前列腺炎、精囊腺炎、睾丸附睾炎及性传播疾病.在新生儿期治疗包茎及包皮过长具有花费少、效益高、安全性高的特点.综述了新生儿包茎及包皮过长的手术治疗进展,呼吁国人重视新生儿包茎及包皮过长的治疗.     

Phimosis and topical steroids: new clinical findings

Phimosis has been defined as unretractable foreskin without adherences and/or a circular band of tight prepuce preventing full retraction. The aim of this study is to evaluate the efficacy (response rate) of topical steroids for the treatment of tight phimosis at different age stages. After using the same medication with different dosage schemes, a retrospective analysis was carried out to assess the efficacy of topical steroids in the treatment of tight phimosis. Patients were divided into three groups: group A (betamethasone scheme A), group B (betamethasone scheme B) and group C (control group). Remission of phimosis, with a complete exposure and without a narrowing behind the glans, was considered a complete response to treatment. The outcomes were then related to dosage scheme and patient’s age. The dosage for group A was more effective than the dosage for groups B and C (control group). Phimosis resolved in 90% (group A), 72% (group B) and 56% (group C) of cases. A successful treatment was closely related to the age of patients at the beginning of steroid application. The results showed that treatment with topical steroids, which in general gives good results, proved to be much more successful in patients aged between 4 and 8 years, suggesting the efficacy of an early beginning of the treatment.     

不同年龄包茎和包皮过长患者包皮组织中触觉小体的观察

目的观察不同年龄包皮组织中触觉小体的变化规律。方法收集3～59岁包茎及包皮过长组织标本204例。免疫组化方法对标本中触觉小体进行染色，观察每例标本中触觉小体密度。应用卡方检验和线性回归方法分别对包茎和包皮过长触觉小体密度差异以及与年龄相关性进行统计学分析。结果包皮过长组织中触觉小体密度婴幼儿期以后渐增加，15岁达到最高，20岁前包茎和包皮过长组织中触觉小体密度无明显差异，其后，包皮过长组织呈下降趋势。包皮过长组织中触觉小体密度与年龄呈负相关关系（r=-0、236，P=0．009），包茎组织中触觉小体密度与年龄间虽呈正相关关系，但无统计学意义（r=0、193，P=0．084）。结论包皮过长组织中触觉小体密度与外生殖器发育成熟同步，并与成年男性性功能状态一致。成年包茎组织中触觉小体持续较高水平可能是一种生理性代偿。     

包皮过长的手术治疗进展

自上个世纪80年代以来,泌尿外科手术技术不断进步,逐步向着减轻伤痛,减少出血等微创方式发展。如今,临床采取的包皮手术普遍还是以传统、电刀、激光等方式进行环切术为主。该文对治疗包皮过长中常用的治疗方法和研究进展综合文献进行综述。     

包皮环切术采用连续外翻缝合法50例分析

目的:探讨包皮环切术采用连续外翻缝合法治疗包茎和包皮过长的疗效。方法:采用连续外翻缝合法治疗50例包茎和包皮过长的患者,并与20例行传统包皮环切术治疗的患者进行比较。结果:50例采用连续外翻缝合法患者均获成功,手术时间短于传统方法,愈合时间两种方法大致相同,拆线时所用时间明显短于传统方法。结论:包皮环切术采用连续外翻缝合法治疗包茎和包皮过长其方法可靠,痛苦小,用时短,费用少,效果好。     

圣环包皮术与包皮环切术的临床疗效对比

目的比较圣环包皮术与包皮环切术的临床疗效。方法对287例包茎、包皮过长患者行包皮环切术(A组),对301例行圣环包皮术(B组),对比分析上述两组患者手术时间、术中及术后出血量、术后并发症等情况。结果两种术式的手术时间、术中及术后出血量间差异均有统计学意义(P<0.05)。两组患者换药率、术后感染率、拆线率以及术后并发症率间差异亦均有统计学意义(P<0.05)。结论圣环包皮术明显优于包皮环切术组,具有微创的特点,值得在临床推广。     

Histopathological evaluation of the preputium in preschool and primary school boys

Objective: To evaluate the dermatopathology of the preputium in preschool and primary school children. Material and methods: The study group consisted of 32 boys subjected to circumcision procedure for religious belief consecutively between June 2003 and September 2003 in our clinic. The removed foreskin is examined by the same pathologist in all cases and the presence of any dermatopathology was noted. Results: The mean age of the children was 6 ± 2 (4–12) years. Three (9.3%) boys had complete phimosis while 2 (6.2%) had partial phimosis. Among 27 (84.3%) cases without phimosis, the histopathological examination of the preputium revealed focal lichenoid cellular infiltrate with epidermal atrophy in 1 (3.1%) patient. This pattern was considered as early lichen sclerosus et atrophicus (LSA). Minor changes were reported in 1 (3.1%) boy namely minimal inflammation and oedema while 1 (3.1%) patient had more marked oedema and acute inflammatory cell infiltration (diagnosed as balanoposthitis). Three (9.3%) preputium specimens revealed evidence of chronic inflammation. Finally 2 (6.2%) boys showed increased melanin pigmentation in basal segment of the foreskin. In 5 (15.6%) patients with phimosis 1 (20%) (complete phimosis) had chronic inflammation and oedema while the other (20%) (partial phimosis) had chronic inflammatory infiltrate only. The rest of the boys with phimosis had normal preputial pathology. As a total, 22 (68.8%) of the 32 cases had totally normal preputial foreskin. Conclusion: The presence of foreskin in preschool and primary school children might rarely be associated with important inflammatory dermatoses like LSA even in the absence of phimosis.     

手法扩张术治疗小儿包茎临床体会

目的：探讨手法扩张术辅以湿润烧伤膏治疗小儿包茎的临床疗效。方法：对2000年5月～2007年，对实行手法扩张分离包皮粘连外敷湿润烧伤膏治疗包茎病的资料进行回顾性调查，于治疗后至少6个月以复诊或信函形式了解远期治疗效果。结果：130例患儿的近期与远期疗效均满意，包皮上翻自如，未见复发。结论：手法扩张辅以湿润烧伤膏治疗小儿包茎，是一种简便、微创、有效的治疗方法。     

三种包皮环切术治疗包茎及包皮过长的方法与疗效比较

目的探讨包皮环切的理想术式。方法对548例包茎、包皮过长患者随机分为改良包皮环切术（A组）230例、袖套式包皮环切术（B组）112例、传统背侧切开包皮环切术（C组）206例，对三组术中出血量、手术时间及术后创口出血、血肿、水肿、疼痛、感染、粘连、外观差等并发症进行观察，并进行随访，比较其治疗效果。结果A组术中出血量为（5．3±2．1）mL，B组为（10．2±3．2）mL，C组为（8．3±3．6）mL（P〈0．001）；手术时间分别为（25±7）min、（58±15）min、（31±8）min（P〈0．001）；并发症发生率分别为7．0％、8．9％和12．6％（P〈0．001）。结论改良包皮环切术比传统的包皮环切术及袖套式包皮环切术更具有优越性，其操作简单，耗时短，并发症少，值得推广。