阴茎离断与再植术术式的问题探讨(附1例报告)

目的 :探讨阴茎再植术 ,只吻合尿道和海绵体再植法与一并吻合阴茎动脉、静脉和神经再植法。方法 :报告 1例阴茎离断病例 ,应用只吻合尿道和海绵体方法再植成功。回顾分析近 2 0年阴茎离断再植术 3 5例。结果 :3 5例病例中 ,16例行只吻合海绵体及尿道再植法 ,15例再植成功。有勃起功能 13例 ,9例皮肤感觉存在 ,7例尿道狭窄 ,2例尿漏 ,皮肤缺损 6例。 18例一并吻合阴茎动脉、静脉或 \和神经再植术 ,全部再植成功。 16例有勃起功能 ,皮肤感觉存在 15例 ,2例尿道狭窄 ,尿漏 2例 ,皮肤缺损 8例。结论 :只吻合尿道、阴茎海绵体的再植方法可以再植成功。但有条件者 ,尽量使用一并吻合背动脉、静脉和神经再植法 ,提高再植成功率及阴茎感觉存在率。

Penis taumatic amputation and the discussion of replantation question

Objective: To evaluate the surgery treatment of penile replantation for penile amputation.Methods: Successful penile replantation anastomosing urethra and bulbocavemos as body replantation was achieved in l case of penile amputation.A retrospective analysis of penile replantation was performed in 35 cases in recent 20 years.Results: In 35 casese,penile replantation anastomosing urethra and bulboc avemosus body replantation was undertaken for 16 cases with successful outcome in 15 cases, among shich erectile capacity restored in 13 casese,skin sensation existed in 9 cases,urethral stricture developed in 7 cases,urinary fistula developed in 2 cases,skin impairment appeared in 6 cases,penile replantation anastomosing penile artery,penile vein plus penile nerve was successfully operated in total 18 cases,among which erectile capacity restored in 16 cases,skin sensation extisted in 15 cases,urethral stricture developed in 2 cases,urinary fistula developed in 2 cases,skin impairment appeared in 8 cases.Conclusion: Penile replantation anastomosing urethra and bulbocavemosus body can be operated with successful outcome,but if conditions permit,using penile replantation anastomosing penile artery,penile vein plus penile nerve can enhance the incidence of successful replantation and penile sensation existence.