阴茎化学假体治疗顽固性早泄九例

本文报告用阴茎化学假体治疗顽固性早泄九例,并对结果予以分析。     

AMS三件套可膨胀型阴茎假体植入术治疗勃起功能障碍6例

目的:观察AMS三件套可膨胀型阴茎假体对勃起功能障碍(ED)患者的临床治疗效果。方法:选择阴茎阴囊交界处切口植入AMS三件套可膨胀型阴茎假体,治疗非手术疗法无效的ED患者6例,其中神经源性ED患者4例,阴茎海绵体动静脉瘘ED1例,阴茎海绵体纤维化ED1例。结果:6例ED患者,手术均取得成功。术后随访4～36个月,平均12个月。无排异反应,无假体故障,无尿道损伤,术后性生活满意。1例术中膀胱破裂,1例术后阴茎皮肤表皮坏死,2例包皮水肿,满意率达100%。结论:AMS三件套可膨胀型阴茎假体更接近人体生理,自然,隐蔽性好,使用方便,手术创伤小,成功率高,机械性能可靠,患者满意率高。     

AMS三件套可膨胀型阴茎假体植入术治疗勃起功能障碍6例

目的：观察AMS三件套可膨胀型阴茎假体对勃起功能障碍（ED）患者的临床治疗效果。方法：选择阴茎阴囊交界处切口植入AMS三件套可膨胀型阴茎假体，治疗非手术疗法无效的ED患者6例，其中神经源性ED患者4例。阴茎海绵体动静脉瘘ED1例，阴茎海绵体纤维化ED1例。结果：6例ED患者，手术均取得成功。术后随访4～36个月，平均12个月。无排异反应，无假体故障，无尿道损伤，术后性生活满意。1例术中膀胱破裂，1例术后阴茎皮肤表皮坏死，2例包皮水肿，满意率达100％。结论：AMs三件套可膨胀型阴茎假体更接近人体生理，自然，隐蔽性好，使用方便，手术创伤小，成功率高，机械性能可靠，患者满意率高。     

1例阴茎假体植入术围手术期护理

介绍1例采用阴茎假体植入术治疗性功能障碍的围手术期护理。主要阐述了手术前后的护理重点：即术前做好心理护理，术区严格备皮，卧床生活指导，术后进行一般护理和对阴茎血运、创口的观察护理。该患者术后创口愈合良好，6周恢复性生活。     

1例可膨胀性三件套阴茎假体植入术的护理

阴茎勃起功能障碍是临床上常见的男性性功能障碍疾病,严重影响成年男子的生活质量和自尊,并成为成年男子心身健康的预警信号。可膨胀性三件套阴茎假体植人术已被美国泌尿外科协会（AUA）规定为现代治疗阴茎勃起功能障碍的金标准。可膨胀性三件套阴茎假体包括圆柱体、充吸泵、贮液囊,分别置于阴茎海绵体、阴囊、膀胱间隙中,由连接管相连,     

乙状结肠扭转结肠镜下复位的诊疗(附26例临床分析)

目的:总结乙状结肠扭转的诊治经验。方法:对26例乙状结肠扭转患者的临床表现及治疗方法进行回顾性分析,结合文献讨论乙状结肠扭转的诊治问题。结果:17例经腹部X线检查确诊,7例经肠镜诊断,2例经剖腹探查确诊。26例行结肠镜下复位治疗,24例成功,均无并发症表现;2例手术治疗(乙状结肠一期切除吻合术),痊愈出院,无吻合口漏。结论:老年男性腹痛、腹胀和便秘应考虑本病的可能。对于无肠坏死及腹膜炎的患者,行结肠镜检查有明显优点,诊断后即可试行复位,成功率高,风险小。对于有肠坏死及腹膜炎的患者,应及时手术治疗。     

阴茎假体植入术治疗脊髓损伤后勃起功能障碍1例并文献复习

1病历摘要患者男 ,4 9岁 ,中医师 ,已婚。主诉“外伤后脊椎骨折 ,脊髓损伤性截瘫 2 1年 ,勃起功能障碍 2 1年” ,门诊以“神经性勃起功能障碍”收入院。患者于 2 1年前在一次事故中受伤 ,当地检查Ｌ1 3 骨折 ,双下肢感觉、运动功能丧失 ,大小便失禁 ,在当地医院住院治疗。损伤治愈后偶有晨间勃起或在性刺激时阴茎部分勃起 ,但无法完成性交。此后双下肢明显萎缩 ,阴茎亦无明显晨间勃起 ,但会阴部感觉基本正常 ,性欲存在 ,大小便基本能控制 ,天气变化时偶有尿失禁现象。患者 2 1年来从未有过性交。曾口服西地那非、海绵体注射罂素碱等 ,治疗效…     

2例勃起功能障碍患者行可膨胀型阴茎假体植入术的护理

总结2例勃起功能障碍患者行可膨胀型阴茎假体植入术的护理。术前做好心理护理,帮助患者丢掉传统观念束缚,主动配合手术;严格会阴部皮肤准备,避免术后切口感染。术后阴囊置冰袋2 h,2 h后用医用沙袋放置于阴囊底部适当抬高阴囊,防止或减轻阴囊水肿;严密观察阴茎血供情况,观察阴茎肿胀及龟头的颜色;联合应用抗生素的基础上保持切口敷料及尿道口清洁干燥,拔除导尿管后教会患者正确的排尿方法,防止发生感染;重视患者出院后假体使用方法指导。2例患者手术顺利,未发生并发症,术后随访3个月,性生活满意。     

男性硅胶假体隆鼻术后立即取出1例分析

对男性患者在我院门诊手术室行硅胶假体隆鼻术后24 h内主动要求取出假体1例分析如下.1 病历摘要男,27岁.因自觉鼻背低平3 a,在门诊主动要求行硅胶假体隆鼻术垫高鼻背,术前化验检查无异常,符合我院手术要求.术前查体:T 36.5℃,BP 90/60 mm Hg,P80次/min,R 18次/min.术前与医生沟通表示希望垫高鼻梁中上1/3,与之充分沟通并签署手术同意书后,15:00进入手术室.     

A case of anisakiasis in the sigmoid colon

Colonic anisakiasis is rare because most cases of anisakiasis occur in the stomach. An accurate diagnosis is sometimes difficult because of the rarity and symptom nonspecificity. We should consider the possibility of colonic anisakiasis when examining patients who have a history of consuming raw fish.     

Laparoscopic repair of an incarcerated inguinal hernia containing the sigmoid colon with a colonoscope

Here, we report the first case of laparoscopic surgery to repair an incarcerated colonoscope in an inguinal hernia containing the sigmoid colon. After colonoscopy was performed on a 74-year-old man with positive fecal occult blood test results, the colonoscope could not be withdrawn. A bulge consistent with an incarcerated colonoscope was found on examination of the patient's left inguinal area. Computed tomography revealed and led to the diagnosis of an incarcerated colonoscope in the sigmoid colon within the inguinal hernia. After confirmation during emergency laparoscopic surgery, the incarcerated sigmoid colon was reduced, and the colonoscope was removed under radiographic and laparoscopic guidance. No ischemic changes or serosal injuries were observed, averting the need for resection. A transabdominal preperitoneal approach with a mesh was then used to repair the inguinal hernia laparoscopically. The patient's postoperative recovery was uneventful, and no recurrence was observed at the 1-year follow-up.     

Carcinoma located in a right-sided sigmoid colon: A case report

BACKGROUNDA right-sided sigmoid colon is an extremely rare anatomic variation that should be considered as a possibility by surgeons and radiologists before surgery. Here, we report the first clinical case of a carcinoma in a right-sided sigmoid colon revealed by a preoperative computed tomography (CT).CASE SUMMARYA 56-year-old Chinese man was admitted to the hospital with abdominal pain. CT revealed a redundant sigmoid colon with a mass on the right side of the cecum and ascending colon. Laparoscopy confirmed an abnormal course in the descending colon and sigmoid colon. Subsequently, hemicolectomy was performed in an open manner after laparoscopic exploration. Pathological examination revealed an infiltrative mucinous adenocarcinoma with two lymph node metastases. The patient was discharged without any complications after a week. There were no signs of recurrence or metastasis during the 3-month follow-up period.CONCLUSIONWe report a rare anomaly of a right-sided sigmoid colon with carcinoma, which should be differentiated from ascending colon cancer and pericecal hernia to prevent errors and other surgical complications.     

Melanotic Xp11-associated tumor of the sigmoid colon:A case report

BACKGROUND Melanotic Xp11-associated tumors are rare mesenchymal-derived tumors. So far,most primary melanotic Xp11-associated tumors have been reported in the kidney, and reports of this tumor in the gastrointestinal tract are rare.CASE SUMMARY Here we describe the case of a 25-year-old woman who presented with a melanotic Xp11-associated tumor in the sigmoid colon. Colonoscopy revealed a large mucosal bulge in the sigmoid colon, approximately 32 cm inside the anus.The surface was rough with local erosion. The tumor was brittle on biopsy and bled easily. Computed tomography revealed thickening of the rectal wall with edema. Postoperative pathology indicated the likelihood of a perivascular epithelioid cell tumor. Histologically, the tumor comprised plump epithelioid cells with abundant clear to lightly eosinophilic cytoplasm and round nuclei arranged in an alveolar or trabecular pattern. The tumor cells were strongly positive for HMB-45, Melan-A, Cathepsin K, and TFE3 but negative for vimentin,smooth muscle actin, S100 protein, CD10, CK20, and desmin. The tumor cells had a low Ki-67 labeling index(approximately 2%). Fluorescence in situ hybridization revealed TFE3 fracture. Based on these histologic and immunohistochemical features, a diagnosis of melanotic Xp11-associated tumor of the sigmoid colon was made.CONCLUSION In summary, we report the clinicopathological features of a primary tumor that is extremely rare in the sigmoid colon and review the clinicopathological characteristics of melanotic Xp11-associated tumors, compatible with the very rare tumor termed "melanotic Xp11 translocation renal cancer" in all aspects.     

1例乙状结肠人工阴道成形术病人的护理

先天性无阴道系胚胎期副中肾管汇合后未能向末端伸展所致,多数病人无子宫,有正常的卵巢功能,第二性征发育良好,除原发性闭经外,无其他临床症状[1].如子宫发育正常,在青春期后可出现周期性腹痛及经血潴留,妇科检查外阴正常.     

1例乙状结肠人工阴道成形术病人的护理

先天性无阴道系胚胎期副中肾管汇合后未能向末端伸展所致,多数病人无子宫,有正常的卵巢功能,第二性征发育良好,除原发性闭经外,无其他临床症状^[1]。如子宫发育正常,在青春期后可出现周期性腹痛及经血潴留,妇科检查外阴正常。自1817年Dupuytrein开始用外科方法治疗先天性无阴道以来,已有100多种阴道成形手术方法被临床采用^[2]。2003年12月我中心为1例先天性无阴道病人行乙状结肠人工阴道成形术,现将临床观察与护理报告如下。     

Pediatric sigmoid volvulus of an extremely long sigmoid colon with hypoganglionosis: a case report

Sigmoid volvulus is an extremely rare cause of intestinal obstruction in pediatric patients. This condition occurs when a redundant sigmoid loop with a narrow mesenteric base of attachment to the posterior abdominal wall rotates around its mesenteric axis. This situation might result in vascular occlusion and large bowel obstruction. There are only a few predisposing factors of sigmoid volvulus, such as a long-term history of constipation or pseudo-obstruction with an excessive sigmoid colon. Underlying hypoganglionosis can also lead to large bowel obstruction. There have only been two reported cases of hypoganglionosis with sigmoid volvulus, and both were in adults. Sigmoid volvulus usually presents with abdominal pain, nausea, vomiting, constipation and abdominal distension, an absence of stool, or the presence of melenic stool in the rectum. Initial treatment options are non-surgical for stable patients, although surgical management might be necessary. If sigmoid volvulus is not recognized and resolved, it may lead to serious complications and death. Pediatric sigmoid volvulus is frequently the fulminant type, and therefore, a decision about treatment must be prompt. We present an unusual pediatric case of an extremely long sigmoid colon with hypoganglionosis, which twisted and caused obstruction. This condition was resolved with surgical resection.     

Contrast-enhanced sonographic appearance of malignant fibrous histiocytoma in the sigmoid colon: A case report

Malignant fibrous histiocytoma (MFH) of the sigmoid colon is extremely rare and imaging characteristics of MFH during contrast‐enhanced sonography have not been described yet. Here we report the case of a 55‐year‐old man suffering from MFH in the sigmoid colon, with an emphasis on contrast‐enhanced sonography findings. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 40:439–442, 2012     

结肠镜协助腹腔镜手术治疗结肠癌

目的探讨结肠镜协助腹腔镜手术治疗结肠癌的价值。方法对60例确诊结肠癌采用腹腔镜进行手术切除的患者，利用结肠镜协助外科医生术中进行肿瘤病灶及切除范围定位，并对术前未能进行检查的肠段完成检查。结果60例均顺利完成检查及定位，缩短手术时间，同时发现部分病例术前不能见到的肠段有肠息肉。结论结肠镜协助腹腔镜手术治疗结肠癌，对手术中病灶定位切除范围有明显帮助，特别是对直肠癌者。同时也缩短了手术所需的时间。