阴茎部整形术的应用解剖学研究

目的 探讨阴茎及其与邻近组织的解剖关系，为阴茎部整形术提供解剖学基础。方法 对30具(左右60侧)成年男性尸体的阴茎和会阴部进行解剖学观察，对阴茎各部的长度，漏斗韧带和悬韧带与阴茎根关系，阴茎海绵体脚与阴茎血管的关系进行观察和测量。结果 所测成人阴茎体长度为8．13cm；阴茎根长度为7．67cm，海绵体脚长度为5.96～5.98cm。漏斗韧带附着于阴茎根前部，阴茎浅筋膜两侧，并向下延伸为阴囊纵隔，参与组成阴囊和阴茎的悬吊结构；悬韧带附着于阴茎深筋膜背侧，后部增厚与耻骨弓状韧带紧密连结，参与尿道悬吊结构。在阴茎根部与阴茎海绵体脚部之间，有一段既无韧带附着又无骨性附着的海绵体，阴茎背动脉和神经在此处从腹侧转向背侧，阴茎背深静脉由此处穿过尿生殖膈注入盆腔内静脉丛。阴茎深动脉在海绵体脚骨性附着中部进入阴茎。结论 本组30例阴茎体长度的分区测量，阴茎悬吊结构的再认识及海绵体脚与阴茎深动脉的解剖关系对阴茎部整形手术具有重要意义。

Applied anatomic investigation of phalloplasty

OBJECTIVE: To investigate the anatomy of penis and its adjacent organ for phalloplasty. METHODS: Anatomic dissection of penis and perineum was performed on 30 adult male cadavers (60 sides). Observation and measurement were focused on the penile length of different parts, the morphological relationship of infundibular ligament and suspensory ligament with penile radix, and the feature of crus penis with relation to the deep penile artery. RESULTS: The average length of the penile shaft was 8.13 cm, the penile radix was 7.67 cm and the crus penis was 5.96 - 5.98 cm. The deep penile artery penetrated into the crus penis at its middle 1/3. The infundibular ligament attached to superficial fascia of the penis and extended downward to the scrotal septum to constitute the suspensory structure for both of them. The suspensory ligament attached to the dorsal deep fascia of the penis. Becoming thicker, the rear part of the suspensory ligament connected firmly to the pubic arcuate ligament to constitute a part of suspensory mechanism for the urethra. There was a part of cavernous body, which was free from either ligament or bony attachment, between the penile radix and the crus penis, where the dorsal artery and nerve of penis turned around from the ventral to the dorsal aspect of the penis and the penile dorsal vain penetrated the urogenital septum, draining into intrapelvic venous plexus. CONCLUSIONS: The divisional measurement of the penis length, the recognition of the suspensory ligaments and the anatomic feature of the crus penis with relation to the deep penile artery are all of significant importance to improve the operation of phalloplasty.