尿道下裂术后阴茎外观及性功能的远期随访  

Long-term follow-up of hypospadias repairs

作　　者：焦晨炜[1] 吴荣德[1] 于启海[1] 

机构地区：[1]山东大学附属山东省立医院小儿外科,济南250021

出　　处：《中华小儿外科杂志》2009年第4期202-205,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的远期随访手术治疗的尿道下裂病例，评价阴茎外观、性功能，探讨二者的关系。方法通过信访、电话采访及面访，随访1984至1992年间在我院手术治疗的174例尿道下裂患者，做统计学分析。结果仅43例获得完整的随访资料。受访者平均年龄21．6岁。53．5％的受访者不满意阴茎外观，主要嫌阴茎短小或下弯。83．7％的受访者对性功能满意。76．7％勃起质量优良。23．3%勃起不良，主要为勃起时阴茎短小或下弯。39．5％射精不良，主要为射精无力。已经历性生活者18例，88．9％无性交障碍。依患者自己对阴茎外观满意程度作比较，“满意组”的勃起（P〈0．025）和射精（P〈0．025）不良问题较少，有性经历的比例高（P〈0．05）。阴茎外观与性功能的总体评价呈正相关（r=0．469，P〈0．01）。结论尿道下裂患者对阴茎外观的关注程度高。阴茎大小影响阴茎外观和性功能的满意度。部分患者成年后存在勃起、射精或性交问题，但多数人性功能状况良好。阴茎外观越好，性功能越好。Objective The aim of this study was to assess the long-term cosmetic appearance and sexual function after hypospadias surgery. Methods One hundred and seventy four patients who underwent hypospadias repair in this institute between 1984 and 1992 were contacted via email or telephone. Results Only forty-three patients completed the study. The mean patient age at follow-up was 21.5 years. Twenty-three patients （53.5 %） were dissatisfied with their penile appearance. The main concern was small penile size and curvature. Thirty-six （83.7%） of 43 patients were satisfied with o verall sexual function. Of the 43 patients, 76. 7% reported satisfactory erection whereas the remaining 23.3% reported problems with erection. 17 patients （39. 5%） complained of ejaculation problems. Sixteen （88. 9%） of the 18 patients who had experienced sexual intercourse reported no problems during intercourse. Those patients who were satisfied with penile appearance had less problems in achieving erection （P〈0. 025） and ejaculation （P〈0. 025） and were more likely to experience sexual inter course （P〈0. 05）, compared to those who were dissatisfied. The self-rated satisfaction scale correlates positively with the penile appearance and sexual function （r = 0. 469, P〈0. 01 ）. Conclusions Patients who had been operated on for hypospadias have a significant penile image problem. Penile size apparently influences sexual funetion. While some patients have erection, ejaculation and intercourse problems in adulthood, the majority of them have a normal sexual function. The better cosmetic outcome is related with better sexual outcome.

关 键 词：尿道下裂 阴茎 随访研究 

分 类 号：R686[医药卫生—骨科学]