先天性阴茎下弯腹侧矫直技术的有效性观察  

The study of the efficacy of ventral manipulation for correction of congenital chordee without hypospadias

作　　者：陈斌[1] 李养群[1] 李强[1] 黄循镭[1] 段晨旺[1] 李森恺[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院整形二科,北京100144

出　　处：《中国美容医学》2009年第2期152-154,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨先天性阴茎下弯腹侧矫直技术的效力。方法:对本院2000年3月到2008年8月收治的12例(3～27岁,平均6.5岁)不同程度先天性阴茎下弯患者分别采用包皮脱套,尿道周围松解,尿道延伸,横行包皮内板岛状瓣部分尿道再造进行矫治,术中人工勃起实验及术后随访(3～78个月,平均34个月)观察下弯矫直的效果。结果:8例包皮脱套尿道松解患者,1例下弯矫治不全,1例术后1年复发。矫治不全者行背侧折叠缝合后矫正;复发的行瘢痕松解后得到再次矫直,随访1年未见复发。2例尿道延伸加背侧折叠缝合,无复发;2例行尿道切断松解,包皮瓣部分尿道再造的无复发。无血肿,感染,尿瘘,伤口裂开,尿道狭窄,尿道憩室发生。结论:应用腹侧技术(包皮脱套,尿道松解;尿道延伸;部分尿道重建)可以矫直先天性阴茎下弯,背侧技术(阴茎背侧白膜折叠缝合)可以不用或作为辅助手段用于修正小的弯曲改善形态,以减少阴茎长度的缩减。Objective The aim of this study was to retrospectively assess the efficacy of the ventral surgical techniques in chordee without hypospadias. Methods Between March 2000 and August 2008,12 patients, ranging in age from 3 to 27 （mean 6.5） years, had chordee without hypospadias and underwent penile shaft degloving （8 cases）, extensive mobilization of the urethra and dorsal plication （2 cases）, and reconstructed partial urethra using a tubularized island flap （2 cases）. Follow-up ranged from 3 months to 8 years, mean 34 months. Results Of the 8 cases undergoing degloving and releasing, residual curvature was present in 1 subject, and 6 months later, complete correction achieved by a plication of tunica albuginea, another one recurred one year after, and were corrected with a redo operation of scar resected and tunica albuginea placation. Of the 2 cases undergoing extensive mobilization of the urethra and dorsal placation, there was no complication. The 2 cases undergoing urethroplasty were straightened and did not recur during the follow-up. Conclusions The curvature of congenital chordee without hypospadias could be corrected using ventral manipulations （degloving, division and mobilization of the urethra, and urethroplasty）. The dorsal operation （tunica albuginea placation） could be used as an ancillary technique to correct some residual bending. To avoid the risk of penis shortening, the authors suggest more radical and accurate ventral operations for the treatment of this scarce deformity.

关 键 词：先天性阴茎下弯 尿道延伸术 尿道重建术 尿道松解术 

分 类 号：R699.8[医药卫生—泌尿科学]