带蒂岛状包皮内板阴茎成形术治疗先天性重型蹼状阴茎  

PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS

作　　者：黄一东[1] 曾莉[1] 黄桂珍[1] 康磊[1] 黄鲁刚[1] 

机构地区：[1]四川大学华西医院小儿外科,成都610041

出　　处：《中国修复重建外科杂志》2016年第11期1387-1390,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨带蒂岛状包皮内板阴茎成形术治疗先天性重型蹼状阴茎的疗效。方法 2011年5月-2015年5月,采用带蒂岛状包皮内板阴茎成形术矫治23例先天性重型蹼状阴茎。患儿年龄2岁8个月~8岁3个月,平均4岁8个月。根据El-Koutby＆El Gohary分类法,单纯型蹼状阴茎3级14例;复合型蹼状阴茎9例,其中1型2例、2型2例、3型5例。阴茎长度2.1~5.4 cm,平均3.4 cm;阴茎阴囊角130~160°,平均144°。龟头均不能外露。患儿无其他泌尿系统疾病,无阴茎手术史。结果 手术均顺利完成。术后即刻测量阴茎长度3.6~6.4 cm,平均4.7 cm;阴茎阴囊角90~110°,平均97°。阴茎、阴囊皮肤分界清晰,阴茎腹侧无蹼状皮肤、阴囊皮肤遗留。切口Ⅰ期愈合。患儿均获随访,随访时间12~41个月,平均25个月。无继发性阴茎下曲,阴茎头感觉无异常、阴茎阴囊角正常,排尿正常。结论 带蒂岛状包皮内板阴茎成形术治疗先天性重型蹼状阴茎,术后阴茎外形良好,切口规整,有效避免了阴茎水肿时间长和阴茎继发下曲等并发症的发生。ObjectiveTo evaluate the effectiveness of preputial pedicled flap phalloplasty for repair of severe webbed penis. MethodsBetween May 2011 and May 2015, 23 boys with severe webbed penis were treated. The age ranged from 2 years and 8 months to 8 years and 3 months （mean, 4 years and 8 months）. According to El-Koutby ＆ El Gohary classification, 14 cases were rated as grade 3 simple webbed penis and 9 cases as compound webbed penis （2 cases of type 1, 2 cases of type 2, and 5 cases of type 3）. The penis length was 2.1-5.4 cm （mean, 3.4 cm）, and the penoscrotal angle was 130-160° （mean, 144°）. All the glans could not be exposed. No other urinary system diseases and no history of penile surgery were found in children. All cases underwent one stage preputial pedicled flap phalloplasty. ResultsAfter successful correction, the penis length was 3.6-6.4 cm （mean, 4.7 cm）; the penoscrotal angle was 90-110° （mean, 97°）. Clear skin boundaries were observed at penile and scrotal parts. No web skin or scrotal skin was left on the penis. Primary healing of incision was obtained, with no necrosis of the flap or infection. All cases were followed up 12 to 41 months （mean, 25 months）. No penile curvature, abnormal sensation of glans, or recurrence of the penoscrotal angle occurred, and the patients had normal urination. ConclusionPreputial pedicled flap phalloplasty can be used as one stage repair for severe webbed penis. The penis is close to natural state and had satisfactory appearance, avoiding the possibility of long-term edema and penile curvature.

关 键 词：先天性蹼状阴茎 带蒂岛状包皮瓣 阴茎成形术 儿童 

分 类 号：R726.9[医药卫生—儿科]