经阴茎根部腹侧阴茎阴囊整形术治疗先天性隐匿阴茎

目的 探讨经阴茎根部腹侧入路的阴茎阴囊整形术治疗先天性隐匿阴茎的临床疗效.方法 针对本病的包茎、阴茎皮肤缺乏、阴茎周围肉膜肌的异常附着、特别是阴茎阴囊交界处皮肤的蹼状改变等,采用不但可使阴茎阴囊蹼状改变得到整形,也利于阴茎的充分松解和固定,还可达到延长阴茎皮肤目的的楔形皮肤切口.同时还采用包皮口横切后外板纵形剪开,背侧楔形切除多余内板的的方法,不但解除了包茎,也避免了过多的内板使用.结果 近10年间用此术式治疗先天性隐匿阴茎359例,年龄最小3岁,最大14岁,其中5～7岁224例(62.4％).术后获半年以上随访者265例(73.8％),其中阴茎显露良好,无退缩现象、无包茎、阴囊皮肤无臃肿现象、切口无瘢痕形成和排尿通畅者共247例(93.2％).术后早期出现阴囊血肿7例.远期并发症包括:腹侧切口瘢痕形成3例,后经瘢痕切除治愈.包皮口出现瘢痕环形狭窄并影响阴茎头外露5例,门诊经瘢痕切除治愈.外观仍显阴茎短小10例(4.6％),但经外用睾酮霜2个月后外观明显改善毋需进一步治疗.结论 结果显示此方法简单,效果显著,且并发症多可预防,是一种治疗先天性隐匿阴茎的好术式.

A new technique for the correction of the congenital buried penis through the ventral of penis root in children

Objective We report our results using a new technique for repair of buried penis through the ventral of the penis root.Methods Becauseof phimosis,the deficiency of skin and abnormal attachments of the dartos and Buck's fascia,our technique involves a wedge-shaped cut of the ventral penis skin,fixation of the subcutaneous penile skin at the base of the degloved penis to Buck's fascia,a circumferential penile incision made subcoronally,splitting of the ventral outer preputial skin longitudinally and the dorsal inner preputial ski obliquely.Results A retrospective review of 359 consecutive patients (age between 3 to 14 years,224 patients between 5 to 7 years (62.4％ )) undergoing buried penis repair in the last 10 years was performed.265 patients (73.8％ ) were followed for median of 6 months after repair.247 patients (93.2％) were determined to havegood outcome.Early postoperative hematoma of scrotum developed in 7 cases,trapped penis developed in 5 cases and 3 cases presented with sever scar in ventral penis skin,which required subsequent excision.Appearance of shortened penis seen in 10 patients (3.7％ ),but this improved after treatment with testosterone propionate.Conclusions The ventral penis approach we have described is a simple and effective procedure with good cosmetic and few complications.