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目的探讨商环联合阴茎背神经切断术治疗早泄合并包皮过长的安全性及可行性,为早泄合并包皮过长患者寻求一种更微创简便的临床术式。方法收集连云港市第二人民医院2014年1月至2015年10月收治的早泄合并包皮过长患者110例,按收治时间随机分为两组,试验组55例:商环联合阴茎背神经切断术组,对照组55例:传统开放包皮环切术+阴茎背神经切断术。对比分析两组患者的手术时间、出血量、疼痛评分、平均性交时间、术后并发症、术后性生活满意度、阴茎外观满意度、术后龟头麻木感等各项指标。结果试验组手术时间平均为(22.3±1.67)min,手术平均出血量为(4.93±0.76)ml,术后24 h患者疼痛评分(VAS)为(3.28±0.04)分,平均性交时间(7.99±0.79)min,性生活满意度92.8%(51/55),外观满意度为91.8%(49/55)。主要并发症的发生率为:系带切口裂开1.80%(1/55)、系带区感染1.80%(1/55)、系带中、重度水肿3.60%(2/55)、出现龟头麻木感7.20%(4/55)。对照组手术时间(56.4±2.89)min,手术平均出血量(15.1±2.11)ml,术后24 h患者疼痛评分(VAS)为(5.37±0.58)分,平均性交时间(5.89±0.65)min,性生活满意度63.7%(35/55),外观满意度为76.3%(39/55)。主要并发症的发生率为:系带切口裂开9.09%(5/55)、感染10.9%(6/55)、系带中、重度水肿16.3%(9/55)、出现龟头麻木感7.20%(4/55)。与对照组相比,试验组患者手术时间、出血量、疼痛评分、平均性交时间、外观满意度、性生活满意度方面,差异均具有统计学意义(t=75.59,P=0.000;t=33.56,P=0.000;t=26.74,P=0.000;t=15.09,P=0.000;χ2=7.698,P=0.010;χ2=5.682,P=0.030)。试验组患者术后并发症发生率低于对照组,但差异无统计学意义(P均>0.05)。结论商环联合阴茎背神经切断术治疗早泄合并包皮过长,具备简单易行,手术时间短,微创,并发症发生率低,受术者易于接受,术后满意度高等优点,有高度的临床应用安全性及可行性,是一种优质的临床术式。
Objective To investigate the safety and feasibility of commercial ring combined with penile dorsal rhizotomy for the treatment of premature ejaculation with redundant prepuce, and to seek a more minimally invasive and simple clinical procedure for patients with premature ejaculation complicated by redundant prepuce. Methods A total of 110 patients with premature ejaculation complicated by prepuce of the Second People’s Hospital of Lianyungang City from January 2014 to October 2015 were enrolled and randomly divided into two groups according to the duration of treatment: 55 cases in the experimental group: commercial ring combined with dorsal penile nerve transection Group, control group of 55 cases: the traditional open circumcision + dorsal penile nerve transection. The operative time, bleeding volume, pain score, average sexual intercourse time, postoperative complications, postoperative sex life satisfaction, penile appearance satisfaction, postoperative glans numbness and other indicators were compared between the two groups. Results The mean operative time was (22.3 ± 1.67) min and the average amount of bleeding was (4.93 ± 0.76) ml in the experimental group. The pain score (VAS) was (3.28 ± 0.04) at 24 h and the mean duration of intercourse (7.99 ± 0.79) min, sexual life satisfaction 92.8% (51/55), appearance satisfaction 91.8% (49/55). The incidence of major complications was 1.80% (1/55) in laceration incision, 1.80% (1/55) in laceration area, 3.60% (2/55) in lacement and severe edema, Sense of 7.20% (4/55). The mean operative time (56.4 ± 2.89) min and mean operative blood loss (15.1 ± 2.11) ml in the control group were (5.37 ± 0.58) and mean intercourse time (5.89 ± 0.65) min at 24 h Sexual life satisfaction was 63.7% (35/55) and appearance satisfaction was 76.3% (39/55). The incidence of major complications was: laceration of laceration was 9.09% (5/55), infection was 10.9% (6/55), laceration of severe edema was 16.3% (9/55), glans numbness was 7.20% (4/55). Compared with the control group, the patients in the test group had statistically significant differences in operation time, bleeding volume, pain score, average sexual time, appearance satisfaction and sex life satisfaction (t = 75.59, P = 0.000; t = 33.56 , P = 0.000; t = 26.74, P = 0.000; t = 15.09, P = 0.000; χ2 = 7.698, P = 0.010; χ2 = 5.682, P = 0.030). The incidence of postoperative complications in the experimental group was lower than that in the control group, but the difference was not statistically significant (all P> 0.05). Conclusion The combination of commercial circle and penile dorsal rhizotomy for the treatment of premature ejaculation with redundant prepuce has the advantages of simple and easy operation, short operation time, minimally invasive operation, low complication rate, easy acceptance by the surgeon and high postoperative satisfaction. Clinical application of safety and feasibility, is a high-quality clinical operation.