两性畸形外阴整形探讨（附193例）  

Investigation of external genital plastic surgery in hermaphroditism

作　　者：张恒[1] 卢根生[1] 沈文浩[1] 刘丽梅 彭大振[1] 郑霁[1] 

机构地区：[1]第三军医大学,西南医院全军泌尿中心,重庆400038 [2]西南医院病理科

出　　处：《中华内分泌外科杂志》2010年第1期40-42,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨两性畸形的外生殖器整形方法。方法回顾193例两性畸形的外科治疗资料。结果193例均住院治疗；年龄2～38岁，平均15岁；社会性别：男：65；女：128。女性假两性畸形73例，男性假两性畸形80例，真丽性畸形25例，性腺发育不全15例。分别对138例行选择女性性别的外阴整形术，术后女性外观均满意，无尿失禁及排尿困难，术后需定期行阴道扩张29例（其中阴道成形术后6例），随访观察阴道发育情况79例，30例因阴道发育好不需再行外科矫正；对35例行选择男性性别的外阴整形术，术后阴茎平均长度4．3em，尿道均开E1于阴茎头，3例因尿瘘再行手术修补，4例因尿道狭窄行定期扩张术；20例因外生殖器完全呈女性发育未行手术。结论两性畸形性别的选择要根据患者意愿、心理性别、优势性腺和外生殖器发育情况慎重选择，通过成功的外生殖器整形可让患者身心更适应正常的社会生活。Objective To explore the related issues of external genital plastic surgery in hermaphroditism. Methods The data of 193 cases of hermaphroditism who were hospitalized in our department were reviewed and analyzed to summarize our experience of the external genital plastic surgery. Results From March 2005 to December 2009, the medical records and data of follow up of 193 hermaphroditism patients with age ranging from 2 to 38（mean 15 years old） were retrospectively analyzed. Among the 193 patients, 73 were female pseudoher- maphroditism, 80 male pseudobermaphroditism, 25 true hermaphroditism, and the other 15 gonadal dysgenesis. 128 patients were reared as female and 65 male. 138 cases accepted the external genital plastic surgery of female gender. Both the patients and parents were satisfied with the male aedea appearance without enuresis and dysuresia. 29 patients were performed eolpeetasia regularly （6 patients were performed colpoplasty） , 79 were follow-up, 30 were not performed eolpoplasty. 35 eases accepted the external genital plastic surgery of male gender. The average length of penis was 4.3em and the urethral orifice was at the balanus after operation. 3 cases were performed repairing because of urinary fistula and 4 were performed urethral sounding due to urethral stricture. 20 patients were not performed any surgical operation at all. Conclusions It is critical to have a comprehensive consideration including choice of patients and parents of which, dominance gonad, psychological sex and the situ- ation of aedea for the gender selection of hermaphroditism patients. The successful external genital plastic surgery was important to adapt the society for hermaphroditism patients.

关 键 词：两性畸形 外阴整形 性别 

分 类 号：R711.1[医药卫生—妇产科学] R699[医药卫生—临床医学]