Preliminary diagnosis and treatment experience of phalloplasty through scrotal approach for concealed penis
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摘要: 目的 探讨隐匿阴茎的发病机制及其对患者生理和心理的不良影响，了解阴囊入路隐匿阴茎成型术治疗隐匿阴茎的必要性和可行性。方法 总结分析天津市津南医院2020年1月—2022年10月诊治的70例隐匿阴茎患者。所有病例均行经阴囊入路的隐匿阴茎成型术，观察手术前后阴囊阴茎角和阴茎牵拉长度的变化，统计患者术后阴茎外观满意度和心理健康恢复情况。结果 70例患者中，31例通过手术证实会阴部脂肪垫增厚，33例肉膜增生异常和纤维条索组织牵拉束缚阴茎体，6例包皮口狭窄束缚为主。术后包皮水肿5例，伤口感染1例，均通过保守治愈。除1例隐匿阴茎术后1个月复诊阴茎体回缩外，余69例术后阴茎外观满意，阴茎延长效果显著，术后焦虑与抑郁评分明显降低。结论 阴囊入路隐匿阴茎成型术治疗隐匿阴茎疗效显著，阴茎外观满意，阴茎牵拉长度增加，心理健康改善，并发症少，预后良好。Abstract: Objective To investigate pathogenesis of concealed penis and its adverse effects on patients' physiology and psychology, and to understand the necessity and feasibility of phalloplasty through scrotal approach.Methods A total of 70 patients with concealed penis in Tianjin Jinnan Hospital from January 2020 to October 2022 were included. All patients were treated with phalloplasty through scrotal approach. Changes of penis scrotal angle and length of penis stretch before and after operation, satisfaction with the penis appearance and mental health after operation were observed.Results Among 70 patients, 31 cases were confirmed perineal fat pad thickening by surgery, 33 cases of abnormal dartos and fibrous cord tissue pulling and binding the penile body, 6 cases of stricture of prepuce orifice. Five cases of postoperative foreskin edema and one case of wound infection were cured conservatively. One case was diagnosed with penile retraction one month after operation, while other 69 cases were satisfied with the appearance of penis, lengthening of penises were significant, and the scores of anxiety and depression were significantly reduced.Conclusion The phalloplasty through the scrotal approach has significant treatment effects on concealed penis with satisfactory appearance of penis, increased length of penis, improved mental health, less complications, and good prognosis.
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Key words:
- concealed penis /
- scrotal approach /
- phalloplasty /
- stretched penile length
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表 1 69例患者手术前后SPL、阴茎阴囊角及焦虑和抑郁评分比较
X±S 项目 GAD-7评分 PHQ-9评分 SPL/cm 阴茎阴囊角/° 术前 7.3±4.4 10.5±4.1 6.0±1.9 63.8±18.3 术后即刻 8.8±2.81) 4.5±5.41) 术后1个月 1.1±1.31) 1.2±1.41) 8.7±2.61) 4.4±4.51) 与术前比较，1)P < 0.05。 
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[1] 儿童隐匿性阴茎诊治的中国专家共识[J]. 中华男科学杂志, 2021, 27(10): 941-947.
[2] 刘贵中. 小阴茎诊疗进展[J]. 中华男科学杂志, 2019, 25(8): 754-757. doi: 10.13263/j.cnki.nja.2019.08.015
[3] 刘贵中, 白文俊. 小阴茎规范性诊疗进展[J]. 中华男科学杂志, 2022, 28(3): 247-251. https://www.cnki.com.cn/Article/CJFDTOTAL-NKXB202203009.htm
[4] Ngaage LM, Lopez J, Wu Y, et al. Uncovering the Hidden Penis: A Nomenclature and Classification System[J]. Ann Plast Surg, 2021, 86(4): 444-449. doi: 10.1097/SAP.0000000000002483
[5] 侯昱竹, 郭玺, 段燚星. 隐匿性阴茎的病因及治疗研究进展[J]. 山东医药, 2021, 61(18): 98-101. doi: 10.3969/j.issn.1002-266X.2021.18.025
[6] Huang W, Tang D, Gu W. The characteristics and distribution of nerve plexuses in the dartos fascia from concealed penis children[J]. Front Pediatr, 2021, 9, 705155. doi: 10.3389/fped.2021.705155
[7] 高志翔, 刘晓龙. 隐匿阴茎的诊治进展[J]. 中国男科学杂志, 2021, 35(1): 73-75, 80. https://www.cnki.com.cn/Article/CJFDTOTAL-NXXX202101016.htm
[8] Radhakrishnan J, Razzaq A, Manickam K. Concealed penis[J]. Pediatr Surg Int, 2002, 18(8): 668-672. doi: 10.1007/s00383-002-0770-y
[9] Lardellier-Reynaud F, Varlet F, François M, et al. Congenital buried penis in children[J]. Prog Urol, 2011, 21(9): 642-650. doi: 10.1016/j.purol.2011.04.008
[10] 唐达星. 关注小儿隐匿阴茎治疗中的心理因素[J]. 临床小儿外科杂志, 2018, 17(12): 891-893. doi: 10.3969/j.issn.1671-6353.2018.12.003
[11] 岳巍巍. 隐匿阴茎选择青春期前期评估并手术治疗对患者阴茎恢复、家属满意度的影响[J/OL]. 泌尿外科杂志(电子版), 2021, 13(4): 80-83.
[12] 张伟同, 冯勋强, 刘翠苹, 等. 渐进性皮瓣转移技术联合改良Devine术治疗小儿隐匿性阴茎的效果评价[J]. 临床外科杂志, 2022, 30(4): 376-378. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWK202204020.htm
[13] 孟漱石, 李清, 白文俊, 等. 脱细胞真皮基质填充耻骨下间隙应用于成人隐匿性阴茎治疗的效果观察[J]. 中华整形外科杂志, 2021, 37(3): 270-274.
[14] 齐灿, 张铁军, 褚登伟, 等. "纽扣法"带蒂岛状包皮背侧皮瓣转移术在儿童重型隐匿阴茎的应用[J]. 中华小儿外科杂志, 2021, 42(4): 345-349.
[15] Su Q, Gao S, Lu C, et al. Clinical effect of Brisson operation modified by Y-shaped incision for treatment of concealed penis in adolescents[J]. J Int Med Res, 2021, 49(4): 3000605211005951.
[16] Smith-Harrison LI, Piotrowski J, Machen GL, et al. Acquired Buried Penis in Adults: A Review of Surgical Management[J]. Sex Med Rev, 2020, 8(1): 150-157.
[17] 赵星球, 郭永连. 阴茎根部对位"M"和"Y"形切口阴茎延长术[J]. 中国男科学杂志, 2019, 33(1): 53-56. https://www.cnki.com.cn/Article/CJFDTOTAL-NXXX201901013.htm
[18] 黄瑛, 吴小蔚, 宋海臣, 等. 脱细胞真皮基质补片联合自体脂肪注射阴茎增粗术的效果[J]. 中华医学美学美容杂志, 2020, 26(5): 406-409.
[19] 辛钟成, 杨璧铖, 李猛, 等. 脱细胞异体真皮在泌尿生殖疾病手术治疗中的应用[J]. 北京大学学报(医学版), 2019, 51(4): 778-782. https://www.cnki.com.cn/Article/CJFDTOTAL-BYDB201904034.htm
[20] 吴勇, 关勇, 王欣, 等. 经阴茎背侧入路改良Shiraki术治疗小儿隐匿阴茎疗效观察[J]. 临床泌尿外科杂志, 2021, 36(11): 900-903. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202111014.htm
[21] 白文俊. 现代男科学临床聚焦(第2版)[M]. 北京: 科学技术文献出版社, 2022: 69-72.
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