169例男性假两性畸形患者的治疗体会  

Experience of Clinical Treatment of 169 Cases of Male Pseudohermaphroditism

作　　者：张恒[1] 卢根生[1] 季惠翔[1] 沈文浩[1] 李新[1] 鄢俊安[1] 郑霁[1] 

机构地区：[1]第三军医大学西南医院全军泌尿研究所,重庆400038

出　　处：《现代生物医学进展》2013年第18期3486-3487,3498,共3页Progress in Modern Biomedicine

摘　　要：目的:总结男性假两性畸形治疗的临床经验。方法:回顾性分析169例男性假两性畸形患者治疗后的临床资料。结果:169例男性假两性畸形患者,97例选择女性性别,72例选择男性性别,手术平均年龄为7岁。选择男性性别的患者术后阴茎平均长度为5.2 cm,35例出现尿后滴沥,18例再次行手术治疗,8例因阴茎小行手术,5例因尿瘘再行手术修补,5例因尿道狭窄行重吻合术,28例因尿道狭窄需行定期扩张,30例对治疗效果不满意,31例男性担心阴茎小,44例术后社会适应良好。选择女性性别的患者术后无尿失禁及排尿困难,2例再次行手术治疗,其中1例阴蒂肥大,1例尿道阴道瘘,17例因阴道狭窄需定期行阴道扩张(阴道成形术后2例),6例对治疗效果不满意,80例术后社会适应良好的。结论:男性假两性畸形治疗性别选择需在医生的指导下,根据患者及家庭意愿慎重决择,选择男性治疗难度大,术后并发症和社会适应困难比选择女性更明显。Objective：To summarize the experience of clinical treatment of male pseudohermaphroditism.Methods：The clinical data including surgical outcome and psychosocial adjustments of 169 cases of male pseudohermaphroditism admitted in our hispotal from 1997 to 2012 were retrospectively studied.Results：In 169 cases of male pseudohermaphroditism,97 cases accepted effemination genitoplasty,while 72 cases accepted the masculinizing genitoplasty.The average operation age was 7 years old.In the patients accepted the masculinizing genitoplasty,the average length of penis was 5.2cm after treatment,terminal dribbling was found in 35 cases,18 cases accepted redo surgery,including 8 cases for too small penis,5 cases for urinary fistula and 5 cases for urethral stricture,28 patients were performed urethral sounding regularly,31 patients worried about the small penis,30 patients were not satisfacted with the treatment results and only 44 patients adapted society well.In 97 patients accepted effemination genitoplasty,no enuresis and dysuresia after treatment was hound,2 patients accepted redo surgery,including 1 case of clitoral enlargement and 1 case of urethro vaginal fistula,17 patients were performed colpectasia regularly（2 patients were performed colpoplasty）,6 patients were not satisfied with the results,80 patients had good family and social relationship.Conclusion：The guide by experienced urological surgeon to choice sex was important for male pseudohermaphroditism patients and their families.It was difficult for male assignment because of more complications and social problems.

关 键 词：男性假两性畸形 外科治疗 性别 体会 

分 类 号：R699[医药卫生—泌尿科学]