CAJ | 학술논문

目的评价阴囊皮瓣结合阴茎延长术修复阴茎缺损的可行性和临床效果.方法 1999至2008年对7例阴茎缺损患者(年龄19～42岁)采用阴囊皮瓣结合阴茎延长术进行修复.患者术前常态残端阴茎长1.0～3.0 cm,平均2.1 cm;勃起时阴攀长3.0～5.5 cm,平均4.8 cm.先采用阴茎海绵体延长术使阴茎充分延伸,再用阴囊前动脉为蒂的双侧阴囊皮瓣(3例)或整块阴囊前壁皮瓣(4例)转位覆盖延伸的阴茎海绵体创面.阴囊切口直接缝合.结果本术式无需重建尿道,阴囊皮瓣切取方便,手术时间短(3～4 h),操作简单,术中出血少(30～50 ml,平均40 ml).7例患者切口均一期愈合,阴囊皮瓣血运良好,重建的阴茎外观满意.术后随访1～5年,阴茎常态下长5.0～7.5 cm,平均6.4 cm;阴茎勃起时长8.0～10.5 cm,平均9.5 cm;排尿、勃起及射精功能均正常.5例自述性生活满意,1例可以完成性生活.结论采用阴囊皮瓣修复阴茎部分缺损的方法简便而有效,术后阴茎有可以接受的外观和长度,同时具有更好的感觉和勃起功能.
목적 평개음낭피판결합음경연장술수복음경결손적가행성화림상효과.방법 1999지2008년대7례음경결손환자(년령19～42세)채용음낭피판결합음경연장술진행수복.환자술전상태잔단음경장1.0～3.0 cm,평균2.1 cm;발기시음반장3.0～5.5 cm,평균4.8 cm.선채용음경해면체연장술사음경충분연신,재용음낭전동맥위체적쌍측음낭피판(3례)혹정괴음낭전벽피판(4례)전위복개연신적음경해면체창면.음낭절구직접봉합.결과 본술식무수중건뇨도,음낭피판절취방편,수술시간단(3～4 h),조작간단,술중출혈소(30～50 ml,평균40 ml).7례환자절구균일기유합,음낭피판혈운량호,중건적음경외관만의.술후수방1～5년,음경상태하장5.0～7.5 cm,평균6.4 cm;음경발기시장8.0～10.5 cm,평균9.5 cm;배뇨、발기급사정공능균정상.5례자술성생활만의,1례가이완성성생활.결론 채용음낭피판수복음경부분결손적방법간편이유효,술후음경유가이접수적외관화장도,동시구유경호적감각화발기공능.
Objective To evaluate the feasibility and clinical efficacy of a scrotal skin flap in combination with penile lengthening for repairing penile defects. Methods From 1999 to 2008, 7 cases (19 to 42 years old) of penile defects were treated by scrotal skin flap in combination with penile lengthening. The average preoperative length of stubbed penis was 2. 1 cm in flaccid (range:1. 0 to 3. 0cm) and 4. 8 cm in erection (range:3. 0 to 5. 5 cm). All cases were treated with penile elongation. And a bilateral scrotal skin flap supplied by anterior scrotal artery (n =3) or whole anterior scrotum flap (n =4) was used to cover the exposed penile shaft. The scrotal incision was sutured directly. Results There was no need for urethra reconstruction. It was simple to obtain the scrotal akin flap. And the operation might be quickly performed with a lesser hemorrhage as compared with penile reconstruction. The scrotal flaps survived without any necrosis and all wounds healed primarily with an excellent contour and erectile function. When followed up for 1-5 years, the average preoperative penile length was 6. 4 cm in flaccid ( range: 5. 0 to 7. 5 cm) and 9.5 cm in erection (range: 8.0 to 10.5 cm). All cases had normal functions of urination, erection and gonobolia. Five cases had satisfied sexual life and one experienced a sexual life. Conclusions The method of restoring partial penile defect with scrotal skin flaps is both simple and efficacious. Reasonable appearance and penile length are restored in most cases with better sensory and erectile functions.