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目的探讨纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形的疗效。方法 1994年6月-2011年10月,采用纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形患者30例。年龄2～16岁,平均5.8岁。入院检查:阴茎头-舟状窝-尿道外口形态以及与邻近组织关系正常;阴茎长度2.5～6.8 cm,平均4.3 cm;弯曲角度35～70°,平均40.1°。初次手术27例,再次手术3例。皮瓣切取范围1.5 cm×1.3 cm～4.0 cm×2.0 cm。结果下曲畸形矫正后阴茎长度3.0～8.5 cm,平均6.6 cm;弯曲角度0～10°,平均1.2°。术后患者均获随访,随访时间6个月～12年,平均33个月。随访期间无阴茎下曲复发,阴茎头无刺痛、异物感等不适。4例(13.33%)拔除尿管后出现尿瘘,行尿瘘修补术后无复发;2例(6.67%)术后1个月出现尿线变细、排尿困难,给予尿道扩张后症状消失。其余患者均无明显并发症发生,尿流无散射,方向性好。6例随访至成年,诉性功能满意,无明显勃起障碍、勃起疼痛及性交困难等。结论纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形具有操作简便、疗效确切等优点。
Objective To investigate the curative effect of longitudinal pedicle pedicle flap wound urethra intermedia on congenital Donnahoo type IV penile malformation. Methods From June 1994 to October 2011, 30 patients with congenital Donnahoo type IV penile malformations were treated with longitudinal pedunculated wrap pedicle urethral catheterization. Age 2 to 16 years old, average 5.8 years old. Admission examination: penis head - boat nest - urethral orifice morphology and the normal relationship with neighboring organizations; penis length 2.5 ~ 6.8 cm, an average of 4.3 cm; bending angle 35 ~ 70 °, an average of 40.1 °. The first operation in 27 cases, reoperation in 3 cases. Flap cut range of 1.5 cm × 1.3 cm ~ 4.0 cm × 2.0 cm. Results After correction of deformity, the length of penis was 3.0-8.5 cm (mean 6.6 cm). The bending angle was 0-10 ° with an average of 1.2 °. Postoperative patients were followed up for 6 months to 12 years, an average of 33 months. No penile recurrence during the follow-up period, no stinging of the penis head, foreign body sensation and other discomfort. Urinary fistula was found in 4 cases (13.33%) after catheter removal, and no recurrence was found after urinary fistula repair. In 2 cases (6.67%), urine became thinner and dysuria appeared one month after operation, and symptoms disappeared after urethral dilatation. The remaining patients had no significant complications, urinary flow without scattering, good direction. 6 cases were followed up to adulthood, complained of sexual function satisfaction, no obvious erectile dysfunction, erectile pain and difficulty in sexual intercourse. Conclusion Longitudinal pedicle wrap pedicled roll urethra interproximal treatment of Congenital Donnahoo Ⅳ type of penile malformations is simple, effective and so on.