阴茎皮肤撕脱伤患者术后勃起功能评估（附9例报告）

目的：评估阴茎皮肤撕脱伤患者手术治疗后勃起功能的恢复情况.方法：回顾性分析我院20042009年经手术治疗的9例阴茎皮肤撕脱伤患者.吻合手术后,5例连通背深静脉、2条背动脉及至少2条背神经;2例仅连通2条背动脉及至少2条背神经;1例连接了单侧背动脉及同侧背神经;1例连接背深静脉及2条背神经.全部患者入院时均行国际勃起功能指数（IIEF-5）评分;随访时均接受化学假体及RigiScan阴茎硬度检测.并再次评定IIEF-5.结果：术后随访9～64 个月.5例完全吻合患者中,1例RigiScan、化学假体检测及IIEF-5评分均提示勃起功能障碍,手术前后IIEF-5评分无差异,其余4例阴茎勃起功能正常.2例仅吻合2条背动脉及背神经的患者术前IIEF-5评分1例正常,1例提示轻度勃起功能障碍,术后随访时IIEF-5评分均正常.本组另2例患者术后随访时均提示有不同程度的勃起功能障碍,且随访时IIEF-5评分均低于术前.结论：阴茎皮肤撕脱伤手术治疗时,血运的恢复状况可能是预测术后勃起功能的重要因素.

The Evaluation of Postoperative Erectile Function of Patients with Avulsion of Penile Skin(Report of 9 Cases)

Objective：To investigate the erectile function of postoperative patients with avulsion injury of penile skin. Methods：The records of 9 patients who were hospitalized between 2004 and 2009 with penile trauma were re- viewed. All 9 patients underwent reconstructive surgery, 5 were anastomosed the deep dorsal vein, 2 dorsal arter- ies and at least 2 dorsal nerves; 2 were anastomosed the 2 dorsal arteries and at least 2 dorsal nerves; 1 were anas- tomosed one dorsal artery and 2 dorsal nerves at the same side; 1 were anastomosed the deep dorsal vein and 2 dor- sal nerves only. All patients performed the international index of erectile function-5 （IIEF-5） scoring system pre- operatively. In the follow-up period, they were also treated with RigiScan and chemical prosthesis testing and the erectile functions were reevaluated with IIEF-5. Results：The time of follow-up ranged from 9--64 months. Of to- tal 5 patients who received completely anastomosed, 1 had erectile dysfunction, but IIEF-5 scores shows no differ- ence before and after the surgery. The other 4 patients had normal erectile function. In the 2 patients who got 2 arteries and dorsal nerves connected, 1 had normal IIEF-5 score and another had mild erectile dysfunction preoper- atively. However, both patients had normal IIEF-5 score during follow-up. The last two patients had erectile dys- function with different degree, and follow-up IIEF-5 score was lower than the preoperative IIEF-5. Conclusions： The repair of vessels is likely to he the vital factor to predict the postoperative erectile function of patients with avulsion of penile skin.