改良海绵体旋转缝合术治疗先天性阴茎下弯畸形的疗效  

Clinical efficacy of modified corporal rotation technique in the treatment of congenital penile downward curvature

作　　者：王鑫[1] 吴鹏杰[1] 逄城 王劲夫[1] Wang Xin;Wu Pengjie;Pang Cheng;Wang Jinfu(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华泌尿外科杂志》2024年第9期699-704,共6页Chinese Journal of Urology

摘　　要：目的探讨改良海绵体旋转缝合术治疗先天性阴茎下弯畸形的疗效。方法回顾性分析北京医院2021年6月至2022年12月接受手术治疗的32例先天性阴茎下弯患者的临床资料。患者年龄(25.3±5.4)岁,术前阴茎勃起后长度(14.0±1.4)cm,阴茎勃起后周长(12.3±0.6)cm,阴茎勃起后下弯角度(41.8±9.3)。术前国际勃起功能指数-5(IIEF-5)评分(19.6±2.8)分。32例均采用改良海绵体旋转缝合术:采用局麻;在手术器械及缝合方法方面,通过使用整形手术器械和放大镜减少对阴茎神经血管束的损伤,并采用倒置水平褥式缝合将线结包埋在组织内,减少其对患者术后满意度的影响。记录手术时间,以及术后即刻阴茎长度、阴茎周长和下弯角度。于术后1、3、6个月进行随访,记录IIEF-5评分、术后阴茎感觉评分和手术相关并发症(伤口疼痛、感染、切口愈合不良等)。结果术后即刻阴茎勃起长度为(13.9±1.4)cm,与术前相比差异无统计学意义(P=0.127);术后即刻阴茎勃起状态下弯角度为(2.1±1.1)°,与术前相比差异有统计学意义(P<0.01)。术后1、3.6个月IIEF-5评分分别为(20.4±1.7)、(22.0±1.0)、(22.3±0.8)分,与术前相比差异均有统计学意义(P<0.001)。术后1、3、6个月阴茎头感觉完全恢复的患者比例分别为0、31.2%(10/32)、68.8%(22/32),阴茎感觉评分分别为(1.1±0.8)、(3.2±0.6)、(3.7±0.5)分。3例(9.0%)术后出现腹侧伤口愈合不良,经规律伤口换药后完全康复。结论改良海绵体旋转缝合术在有效矫正先天性阴茎下弯畸形的同时可避免阴茎长度的损失,未发现对勃起功能的影响及神经损伤,手术安全性高,具有一定的临床应用价值。Objectivee To evaluate the efficacy of modified corporeal rotation technique in the treatment of congenital penile downward curvature.Methods A retrospective analysis was conducted on the clinical data of 32 patients with congenital penile curvature who underwent surgical procedure in Beijing Hospital from June 2021 to December 2022.The patients age was(25.3±5.4)years old,preoperative erect penile length was(14.0±1.4)cm,preoperative erect penile circumference was(12.3±0.6)cm,preoperative erect penile downward curvature angle was(41.8±9.3)°,and preoperative International Index of Erectile Function(IIEF-5)score was(19.6±2.8).All 32 cases underwent modified corporeal rotation technique with local anesthesia,while the surgical instruments and suturing techniques employed in this study aimed to minimize damage to the penile neurovascular bundle by utilizing plastic surgery instruments and magnifier.Additionally,the use of inverted horizontal mattress sutures,with knots embedded within the tissue,was implemented to reduce their impact on postoperative patient satisfaction.Surgical time,preoperative and immediate postoperative penile length,circumference,and curvature angle were recorded.Follow-ups were conducted at 1,3,and 6 months postoperatively,and IIEF-5 scores,postoperative penile sensation scores,and surgery-related complications(wound pain,infection,poor incision healing,etc.)were recorded.Results The immediate postoperative erect penile length was(13.9±1.4)cm,with no statistically significant difference compared to preoperative length(P=0.127).The immediate postoperative erect penile curvature angle was(2.1±1.1)°,with a statistically significant difference compared to preoperative angle,(P<0.01).IIEF-5 scores at 1,3,and 6 months postoperatively were(20.4±1.7),(22.0±1.0),and(22.3±0.8)respectively,compared with preoperative scores,the differences were statistically significant(P<0.001).The proportions of patients with fully restored glans sensation at 1,3,and 6 months postoperatively were 0,31.2%(10/3

关 键 词：先天畸形 阴茎下弯 改良海绵体旋转缝合术 疗效 

分 类 号：R699.8[医药卫生—泌尿科学]