Application research on the modified Devine surgery with preservation of dorsal penile V-shaped inner plate flap for moderate-severe concealed penis
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摘要: 目的 探究保留阴茎背侧V型皮瓣改良Devine术式治疗中重度隐匿性阴茎的临床效果。方法 收集衢州市人民医院2018年2月—2023年2月的72例行保留阴茎背侧V型皮瓣改良Devine术式治疗的中重度隐匿性阴茎的患儿的临床资料。其中患儿年龄6~15岁，平均(8.3±1.74)岁。本研究纳入标准为中重度隐匿性阴茎患儿，其包皮口夹角大于45°。分析比较患儿的手术时间、术后阴茎伸长长度、包皮水肿及并发症发生率。术后随访1年，采用Boemers标准评估患儿阴茎术后情况，调查患儿对手术后外观效果评价。结果 72例患者平均手术时间为(52.13±9.42) min，术后平均阴茎伸长长度为(2.27±0.31) cm，术后6例患儿出现术后背侧皮瓣明显水肿，予以加压包扎后4~6周恢复正常。术后随访1年，所有患儿阴茎体显露良好，家属对阴茎外观满意，Boemers标准评价72例均为良好。术后随访仅有1例患儿出现阴茎回缩，所有患儿切口无瘢痕狭窄，无明显包皮赘生，无阴茎痛性勃起，远期疗效家长均主观满意。结论 保留阴茎背侧V型内板皮瓣改良Devine术式治疗中重度儿童隐匿性阴茎的疗效较好，能有效补充阴茎背侧皮肤缺损，有利于阴茎恢复至正常形态，而且局部斜形缝合面，可以有效降低术后水肿的发生，避免出现二次狭窄环，降低并发症发生率，提高患儿的生活质量。Abstract: Objective To explore the effects of the modified Devine surgery with preservation of dorsal penile V-shaped inner plate flap on moderate-severe concealed penis.Methods From February 2018 to February 2023, a total of 72 patients treated with the modified Devine surgery with preservation of dorsal penile V-shaped inner plate flap were enrolled from Quzhou People's Hospital. The average age of the children was (8.3±1.74) years old, ranging from 6 to 15 years old. The inclusion criteria for children in this study were patients with moderate to severe concealed penis, with an angle between the prepuce and the ostium greater than 45 degrees. The operation time, postoperative penile elongation, prepuce edema and complications were analyzed and compared. The patients were followed up for one year. The Boemers criteria were used to evaluate the postoperative penile condition, and the patients were investigated to evaluate the postoperative appearance.Results The average operation time was (52.13±9.42) min, and the average postoperative length of penis elongation was (2.27±0.31) cm. Six cases were found postoperative edema, and then compression bandage was used on dorsal flap for 4-6 weeks. All patients were followed up for one year. The penile body of all patients were well exposed, and the family members were satisfied with the appearance of the penis. Boemers criteria evaluated 72 cases as good, but 1 patient had penile retraction during the postoperative follow-up. All patients had no scar stenosis, obvious prepuce excrescence or painless penile erection.Conclusion The modified Devine surgery with preservation of dorsal penile V-shaped inner plate flap is effective in the treatment of moderate to severe concealed penis in children. It can effectively cover the dorsal skin defect of the penis, and help the penis to restore to normal shape. Moreover, the local oblique suture surface can effectively reduce the occurrence of postoperative edema, avoid the occurrence of secondary narrow ring, reduce the incidence of complications, and improve the quality of life of children.
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Key words:
- concealed penis /
- children /
- Devine procedure /
- clinical curative effect
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