209例不同术式环切术治疗包茎和包皮过长

目的评价不同术式环切术治疗包茎及包皮过长的方法和疗效。方法自2001年起,共收治包茎和包皮过长患者209例,包茎85例,包皮过长124例。其中已婚者53例。行剪刀法包皮环切术59例,血管钳法包皮环切术31例,袖套法包皮环切术47例,阴茎根部皮肤环切术72例。结果改良术式(袖套法、根部法)手术时间、术中出血量和术后创口疼痛时间与传统术式(剪刀法、血管钳法)比较差异均有统计学意义(P<0.01)。传统术式发生出血或血肿19例,伤口感染10例,阴茎水肿34例,包皮过长或过短8例;改良术式术后伤口感染2例,阴茎水肿5例,无出血或血肿及包皮过长或过短。总并发症发生率为37.32%,其中传统术式并发症33.97%,改良术式3.35%,对比差异有显著性意义(P<0.01);已婚者性满意度提高23例,其中改良术式18例,差异有统计学意义(P<0.05)。结论严格掌握不同术式的适应证,根据患者情况灵活选择术式可降低并发症发生率,提高婚后性生活质量。

Circumcision for 209 cases of phimosis and redundant prepuce with different procedures

Objective To evaluate the choice of various circumcision procedures for the treatment of patients with phimosis and redundant prepuce. Methods 209 cases of phimosis and redundant prepuce were admitted from 2001,and of these,53 had married,85 with phimosis,124 with redundant prepuce,59 received scissors circumcision,31 received forceps circumcision,47 received sleeve circumcision,and 72 received circumcision of the root-skin of penis. Results The differences between the improved circumcision(circumcision of sleeve and the root-skin of penis) and the traditional circumcision (circumcision of scissors and forceps) in operative time,hemorrhagic amount and painful duration were statistically significant (P<0.01). Postoperative bleeding or hematoma,infection of wound,dropsy of penis,longer or shorter prepuce in the traditional circumcision were 19,10,34,8 cases respectively. Postoperative infection of wound,dropsy of penis in the improved circumcision were 2,5 cases respectively. No bleeding or hematoma and longer or shorter prepuce was happened. An overall complication rate was 37.32%. The complication for the traditional circumcision was 33.97%(71/209),the improved circumcision 3.35%(7/209),there is obvious difference between two groups(P<0.01). Improved satisfaction was obtained in 23 married cases,among them 18 were patients of improved circumcision,there was statistical significant difference (P<0.05). Conclusion It is suggested that a complete mastery on applications of different surgical approach and a proper selection of various surgical methods according to individual patient,s condition can reduce complication of operation and improve quality of sexual life for married patients.