Devine矫正术治疗小儿单纯性隐匿阴茎

目的：总结Devine矫正术治疗隐匿阴茎的疗效。方法：采用Devine术治疗单纯性隐匿阴茎9例，年龄5－14岁，7例为肥胖患儿，其中1例曾行阴茎体固定术失败，3例曾用绒毛膜促性腺激素治疗无效。结果：本组手术后阴茎均显外,凸出2－3cm，随访3－6个月，阴茎无明显回缩，勃起功能正常。结论：隐匿阴茎多因肉膜层发育异常所致，采用Devine矫正术充分切除失去弹性的肉膜层，松解阴茎，是一种治疗小儿单纯性隐匿阴茎的理想术式。     

改良Devine术矫正小儿隐匿性阴茎疗效观察

目的：探讨改良Devine术治疗小儿隐匿性阴茎的临床效果。方法：回顾性分析2002年6月～2010年6月间30例行改良Devine术治疗的真性隐匿性阴茎患儿临床资料。结果：全部手术均获成功,术后伤口Ⅰ期愈合。术后随访6个月～2年,阴茎外观好,发育正常。结论：改良Devine术治疗隐匿性阴茎,手术操作简单、创伤小、临床效果较好。     

隐匿型阴茎的手术治疗(附63例报告)

目的 :探讨隐匿型阴茎的外科治疗原则。　方法 :回顾性分析 1999年 1月～ 2 0 0 2年 12月我院收治的 6 3例隐匿型阴茎患者 ,年龄 1岁 6个月～ 19岁 ,平均 7岁 2个月。根据患者是否合并肥胖与阴茎发育不良而将其分为A和B两组。A组 37例 ,为肥胖合并阴茎发育不良者 ,采用手术 Ⅰ式治疗 ;B组 2 6例 ,采用手术 Ⅱ式治疗。　结果 :术后随访 6个月 ,A组 37例阴茎显露均满意 ,7例发生较重的阴茎包皮水肿 ,3例出现耻骨联合下切口脂肪液化 ,3例耻骨联合下切口凹陷恢复不满意 ,1例出现龟头片状麻木感 ;B组 2 6例中 ,1例术后 7d阴茎回缩 ,余各例阴茎显露满意 ,包皮无明显水肿。　结论 :隐匿型阴茎手术治疗方式多样化 ,阴茎根部被膜的复位与固定是提高手术疗效的关键 ,其自然病程和手术时机有待进一步研究。     

Evaluation and Treatment of Adult Concealed Penis

Concealed penis is a rare congenital disorder most commonly seen in children and the condition and surgical management have been well described. In contrast, there is a paucity of information with regards to adult concealed penis. Adult concealed penis may be due to trapping from skin contraction related to lichen sclerosis, cicatricial scars following surgical procedures, or prepubic adipose tissue causing poor phallic exposure. One of the greatest risk factors for concealed penis is obesity, and as this becomes a national pandemic, the incidence of adult concealed penis may increase. Therefore, a greater number of urologists may be faced with treating this difficult condition. This article reviews the etiology of adult concealed penis and describes the patient evaluation and various surgical approaches.     

两种隐匿阴茎大鼠模型的建立及比较

目的:建立稳定的大鼠隐匿阴茎模型,为探索阴茎包埋对海绵体结构和功能的影响提供实验动物模型。方法:90只2周龄雄性SD大鼠随机均分为A、B、C3组,A组采用阴茎根部内荷包缝合法,B组采用包皮折叠缝合法包埋阴茎,C组为假手术组。在180d内观察两种方法的包埋效果。结果:A组术后4只死于急性尿潴留,5只因尿道口周围软组织感染、皮肤破溃导致包埋失败,3只因包埋过松阴茎伸出;B组术后1只死于麻醉,2只死于急性尿潴留;因阴茎发育和勃起,A组有7只、B组有10只阴茎伸出;C组1只死于麻醉。A组和B组中其余大鼠均有较好的包埋效果,A组包埋成功率为36.7%,B组为56.7%,而且可以在实验中任何时候解除包埋。结论:包皮折叠缝合法和阴茎根部内荷包缝合法均能建立稳定的、且与人类隐匿阴茎自然病程较为一致的2周龄大鼠隐匿阴茎动物模型。     

Retractile Mesenteritis: Report of a Case

Retractile mesenteritis is a rare idiopathic inflammatory process of the mesenteric adipose tissue. A 58-year-old woman who presented with acute abdominal pain and vomiting underwent laparotomy for a small bowel obstruction of unknown etiology. The laparotomy showed dilated small bowel loops and multiple tumor-like fibrous plaques in the mesentery. Histological examination revealed nonspecific chronic inflammatory processes of the mesentery. The computed tomography finding of increased density of the mesenteric fat, known as the fat-ring sign, in a patient with small bowel obstruction and no surgical history would suggest this rare diagnosis.     

经阴茎腹侧阴茎周围组织环形松解、白膜固定包皮整形术治疗小儿埋藏阴茎

目的:探寻治疗小儿埋藏阴茎的简单、有效手术方法。方法:根据埋藏阴茎的临床特点,设计一种新的手术方式即经阴茎腹侧阴茎周围组织环形松解、白膜固定包皮整形术:阴茎根部腹侧"V"形切口,环形松解阴茎浅、深筋膜及异常附着的肉膜肌、纤维索带,阴茎根部左、右侧白膜分别与胸膝位耻骨结节前筋膜的1、11点各缝合固定1针进行手术,共治疗小儿埋藏阴茎38例,术后随访2~6个月。结果:38例出院时阴茎外观形态均满意,阴茎体完全显露。术后随访期间35例(92.1%)阴茎外观形态满意,2例仍有阴茎轻度埋藏,1例出现包皮口瘢痕狭窄。结论:采用经阴茎腹侧阴茎周围组织环形松解、白膜固定包皮整形术治疗小儿埋藏阴茎是一简单、有效的手术方法,具有推广应用价值,但仍需积累更多的病例和更长时间的随访。     

Penis deviation

Penile deviation has been gaining in importance as a symptom of several diseases. There are congenital forms (congenital penile deviation, hypo- and epispadias) as well as acquired forms (induratio penis plastica, traumatic deviation, urethral manipulation syndrome). History and autophotography are the most important diagnostic procedures. The therapeutic procedure is corporaplasty according to Nesbit-Kelami.     

Der vergrabene Penis

The buried penis describes a bunch etiologies and clinical presentations of which the congenital form is rare. In the past different techniques had been described, using inner prepuce after mobilization to cover the penile shaft. This can lead to persistent edema of the skin. We developed a new technique to reduce the rate of postoperative edema.     

Schwannoma of the Penis

A case of a schwannoma of the penis is reported that was treated by surgical excision and diagnosed by S-100 immunoperoxidase staining.     

Melanosarkom des Penis

Ohne Zusammenfassung     

Retractile testes: an outcome analysis on 150 patients

Background/Purpose

Retractile testes are testicles that can be brought down into their normal position in the scrotum but then immediately retract upward and out of the scrotum. The purpose of this study is to provide data on the outcome of pediatric patients with retractile testes.

Methods

A retrospective analysis was conducted on prospectively collected data on the outcome of 150 consecutive patients with retractile testis examined and followed up by one pediatric surgeon from April 1982 to April 1999, inclusive.

Results

Age at presentation was 5.2 ± 3.0 years, and follow-up duration was 3.8 ± 3.0 years. The number of retractile testes was 205, right-sided for 58 patients (38.6%), left-sided for 37 (24.6%), and bilateral for 55 (36.7%). Family history of retractile testis was positive in 8 patients (5.3%). Thirty-four patients required surgery (22.7%); indication for surgery was given when retractile testes ascended and became cryptorchid or if testicular size decreased during follow-up. Orchidopexy was required more frequently (P < .001) in patients with an associated hernia (68.8% of cases) than in patients without hernias (9.2%). One patient with spontaneous testicular descent during follow-up had a testicular carcinoma.

Conclusions

These findings suggest that the majority of patients (77.3%) with retractile testes have a spontaneously favorable evolution by 14 years of age and do not require surgical treatment. The authors report the first case of testicular carcinoma in a patient with retractile testis, and this indicates that these patients should be followed up even after testicular descent.     

阴茎整形术后阴茎损伤的治疗

目的 通过正确、及时的治疗减轻阴茎损伤的程度和范围,防止损伤阴茎完全坏死.方法 通过动脉多普勒检查,二点分辨觉检查和皮肤触觉检查,判断阴茎损伤的程度.损伤1周之内施行阴茎白膜切开减张,全身使用抗凝药物或肝素化,同时行高压氧治疗.1周之后出现皮肤坏死立即行清创术,把损伤的阴茎体用阴囊皮瓣覆盖.如果损伤阴茎全部坏死,清创后用局部皮瓣修复残端,6个月后行阴茎再造术或阴茎延长术.结果 2001年至2006年间共收治了32例阴茎严重损伤的病人,其中16例病人损伤后1周内入院治疗,病情获得了缓解,其他病人4周后入院,治疗后病情没有缓解,造成损伤的阴茎全部坏死.其中5例病人阴茎部分缺损二期行阴茎延长术,4例完全缺损行阴茎再造术.结论 早期、及时和正确的治疗对减轻或阻止阴茎进一步损伤的程度和范围至关重要.