免龟头缝扎牵引加内板筋膜剔除改良Devine术治疗隐匿性阴茎  

Treatment of concealed penis by modified Devine procedure of traction without glans suture combined with removal of inner plate fascia

作　　者：王成 钱小强[2] 周硕明 汤润 陆枫 吴博 吴泽明[1] 朱应祥 康健[2] WANG Cheng;QIAN Xiaoqiang;ZHOU Shuoming;TANG Run;LU Feng;WU Bo;WU Zeming;ZHU Yingxiang;KANG Jian(Department of Urology,People’s Hospital of SND,Jiangsu,215129,China;Department of Urology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)

机构地区：[1]苏州高新区人民医院泌尿外科,江苏苏州215129 [2]上海交通大学医学院附属新华医院泌尿外科

出　　处：《临床泌尿外科杂志》2020年第8期648-650,共3页Journal of Clinical Urology

摘　　要：目的:探讨免龟头缝扎牵引加包皮内板处皮下筋膜剔除改良Devine术治疗隐匿性阴茎的临床疗效。方法:回顾性分析总结我院2017年1月~2019年12月收治的30例隐匿性阴茎患者,年龄3~15岁,平均8.5岁。其中16例患者采用免龟头缝扎牵引加包皮内板处皮下筋膜剔除改良Devine术,14例采用传统的Devine术,对其术中出血量,手术时间,术后包皮水肿程度,术后疼痛评分进行对比,比较两者差异。结果:16例行改良Devine术患者手术术中出血量为(4.2±2.0)mL,手术时间(47.9±7.5)min,术后出现阴茎轻度水肿1例(6.3%),术后疼痛VAS评分(2.0±0.8)分。14例传统Devine术,患者手术术中出血量为(7.1±2.9)mL,手术时间(51.6±6.8)min,术后出现阴茎水肿6例(42.9%),术后予以加长包扎时间,随访2个月后水肿减轻,术后疼痛VAS评分(4.0±1.0)分,在术中出血量、术后水肿发生率及术后疼痛方面改良Devine组优于传统Devine组,在手术时间方面无明显差异,所有患者术后随访1年,患者均无水肿,外观良好,未出现阴茎回缩现象。结论:免龟头缝扎牵引加包皮内板处皮下筋膜剔除改良Devine术治疗隐匿性阴茎手术效果明显,术中对龟头不造成损伤,手术出血少,且操作简便,视野暴露良好,手术时间短,术后水肿发生率下降,术后疼痛减轻,是治疗隐匿性阴茎的较好的方法。Objective:To explore the clinical effect of modified Devine procedure of traction without glans suture combined with subcutaneous fascia removal in the inner plate of prepuce in the treatment of concealed penis.Method:Thirty patients with concealed penis treated in our hospital from January 2017 to December 2019 were analyzed retrospectively,aged from 3 to 15 years old,with an average of 8.5 years old.Among them,16 patients were treated by modified Devine operation of traction without glans suture combined with subcutaneous fascia removal at the inner plate of prepuce,while other 14 patients were treated by traditional Devine.The intraoperative bleeding volume,operation time,postoperative prepuce edema degree and postoperative pain score were compared.Result:In 16 patients with modified Devine operation,the intraoperative blood loss was(4.2±2.0)mL,and the operation time was(47.9±7.5)min.The postoperative penile edema occurred in 1 case(6.3%),and the postoperative pain VAS score was(2.0±0.8).In 14 cases of traditional Devine,the intraoperative blood loss was(7.1±2.9)mL,and the operation time was(51.6±6.8)min.Penile edema occurred in 6 cases(42.9%),so the postoperative bandaging time prolonged.The edema was relieved after 2 months of follow-up period,and the postoperative pain VAS score was(4.0±1.0).The modified Devine group was superior to the traditional Devine group in intraoperative blood loss,postoperative edema incidence and postoperative pain,but there was no significant difference in operation time.Conclusion:The modified Devine operation of traction without glans suture combined with subcutaneous fascia removal at the inner plate of the prepuce is effective in the treatment of concealed penis with no damage to glans,less bleeding,simple operation,good visual field exposure,short operation time,low incidence of postoperative edema and little postoperative pain,so it’s a better method for concealed penis.

关 键 词：改良Devine 隐匿性阴茎 免龟头缝扎牵引 包皮内板处皮下筋膜剔除 

分 类 号：R697[医药卫生—泌尿科学]