单纯阴茎腹侧白膜切开术纠正尿道下裂阴茎下弯效果探讨  

Study on the effect of simple incision of ventral tunica albuginea on the correction of penile curvature in hypospadias

作　　者：沈一丁[1] 诸林峰 陶畅[1] 茹伟[1] 赵一俊 王展[1] 杨帆 唐达星[1] 何屹 汪雪萍 Shen Yiding;Zhu Linfeng;Tao Chang;Ru Wei;Zhao Yijun;Wang Zhan;Yang Fan;Tang Daxing;He Yi;Wang Xueping(Department of Pediatric Urology surgery,the Children′s Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Urology surgery,Affiliated Hospital of Jiaxing University,Jiaxing 314000,China)

机构地区：[1]浙江大学医学院附属儿童医院泌尿外科,杭州310000 [2]嘉兴学院附属医院泌尿外科,嘉兴314000

出　　处：《中华医学杂志》2020年第22期1704-1707,共4页National Medical Journal of China

摘　　要：目的探讨单纯白膜切开的阴茎腹侧延长术纠正尿道下裂中海绵体不对称所致阴茎下弯的效果。方法回顾分析2016年1月至2018年12月间39例利用单纯白膜切开的阴茎腹侧延长术纠正海绵体不对称的尿道下裂患儿(其中36例为浙大儿院泌尿外科病例,3例为嘉兴第一医院泌尿外科病例)。患儿年龄0.5~5岁,中位年龄1.1岁。第一期手术,先给予阴茎皮肤肉膜彻底脱套松解皮肤及筋膜引起的牵拉,再离断尿道板解除短尿道因素,然后测量阴茎背侧长度A和伸直前阴茎腹侧长度B,白膜切开术使阴茎完全伸直后测量阴茎腹侧长度C;第二期手术,人工勃起试验观察阴茎下弯情况,测量阴茎背侧长度D和阴茎腹侧长度E。比较阴茎伸直前后背侧腹侧的长度。结果第一期手术中测得阴茎背侧长度A为33~39(35.6±3.2)mm;伸直前阴茎腹侧长度B为28~35(29.8±2.8)mm;伸直后阴茎腹侧长度C为32~38(34.3±2.1)mm。B和C两者差异有统计学意义(P<0.05);A和C差异无统计学意义(P>0.05)。第二期手术中测得阴茎背侧长度D为34~41(36.4±2.5)mm,测得阴茎腹侧长度E为33~40(35.7±3.6)mm,两者差异无统计学意义(P>0.05)。患儿随访0.5~2.5年,平均1.7年。所有患儿根据侧面照片测量勃起时阴茎下弯角度均<15°。结论单纯阴茎腹侧白膜切开术有效纠正阴茎海绵体不对称所致阴茎下弯,近期效果佳;术中测量比较腹侧及背侧阴茎的长度可以验证其延长腹侧阴茎的效果。Objective To investigate the therapeutic effect of simple tunica albugineaincision and ventral penile lengthening surgery on the correction of penile curvature due to asymmetry of the cavernous bodies in hypospadias.Methods A retrospective analysis was performed in 39 children with hypospadias who underwent simple tunica albuginea incision and ventral penile lengthening surgery for correcting asymmetry of the cavernous bodies from January 2016 to December 2018(36 of them were from Department of Pediatric Urology surgery,The Children′s Hospital,Zhejiang University School of Medicine,and 3 from Department of Urology surgery,Affiliated Hospital ofJiaxing University),all of whom aged from 0.5 to 5,with a median age of 1.1 years.During the first stage of the operation,firstly penile skin and sarcoma was released by completely degloving the skin and fascia of penis,secondly the factor of short urethral plate was solved by transection of urethral plate,and then the dorsal length of penis(A),the ventral length of the penis before and after straightening by incision of tunica albuginea(B and C)were measured and recorded;onto the second stage of the operation,an artificial erection test was performed to observe the curvature of the penis,the dorsal and ventral length of the penis(D and E)were measured.The dorsal and ventral length of the penis before and after straightening were compared.Results The dorsal length of penis(A)was 33-39(35.6±3.2)mm,the length of ventral length of penis before straightening(B)was 28-35(29.8±2.8)mm and the length of ventral length of penis after straightening(C)was 32-38(34.3±2.1)mm,which were measured during the first stage of operation,and the difference between B and C was statistically significant(P<0.05),while the difference between A and C was not statistically significant(P>0.05).The dorsal length of penis(D)was34-41(36.4±2.5)mm and the ventral length of penis(E)was 33-40(35.7±3.6)mm,which were measured during the second stage of operation,and there was no significant difference b

关 键 词：尿道下裂 阴茎下弯 阴茎白膜 分期手术 

分 类 号：R726.9[医药卫生—儿科]