Winter手术治疗顽固性缺血性阴茎异常勃起

目的:回顾性评价Winter手术治疗顽固性缺血性阴茎异常勃起的有效性及随访结果。方法:2003年6月-2008年8月,我院收治了9例经保守处理无效的顽固性阴茎异常勃起患者。平均年龄37.3岁(26~54岁)。其中罂粟碱海绵体注射史2例,急性粒细胞性白血病3例,其余无明显诱因。平均异常勃起时间12.6h(7~60h)。局麻下,采用尖刀经一侧阴茎头部直插入海绵体内做十字切开,配合肝素盐水冲洗,直至阴茎疲软。若单侧分流效果不佳,同样方法处理对侧。结果:接受单侧分流者2例,双侧分流者7例。仅1例患者术后24h又再发异常勃起,有效率为88.9%。大部分患者7~10d后出院。随访5例,平均随访2.8年。勃起功能满意或基本满意(≥3分)3例,不满意或完全勃起障碍(<3分)2例。结论:Winter手术可有效缓解顽固性缺血性阴茎异常勃起,术后部分患者可维持满意的勃起功能。

Winter Surgery for Refractory Ischemic Priapism

Objective： To retrospectively evaluate the efficacy and follow-up of Winter surgery for refractory ischemic priapism. Methods：From June 2003 to August 2008,with Winter surgery we treated 9 patients of priapism who were refractory to conservative management. Mean age was 37.3 years （ 26-54 years）. 2 cases had a papaverine injection. 3 patients had identified AGL during hospital stay. The others had no significant factors. The mean duration was 12.6h（7- 60h）. With local anesthesia, a sharp-point knife was inserted transglans to corporal cavernosa to do a crucial incision. Heparin-fluid irrigation was performed until detumescence. If one-side shunt was not effective, the opposite shunt was given. Results： 2 cases were shunted in one-side, 7 cases were shunted in double-side, only 1 case needed re-procedure. The effective rate was 88. 9%. Majority of cases had discharged in 7-10 days. 5 cases received a mean 2.8 years＇following-up. 3 cases were satisfactory or generally satisfactory（≥3）,2 cases were not satisfactory or complete erectile dysfunction（〈3）. Conclusion： Winter surgery could be effective to treat refractory ischemic priapism, some patients still maintain satisfactory erection during a long term follow-up.