McDougal W Scott
Department of Urology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
J Urol. 2003 Sep;170(3):711-6. doi: 10.1097/01.ju.0000067625.45000.9e.
This article presents a simple classification of lymphedema of the external genitalia, which is useful for selecting the appropriate therapy, and evaluates our experience with the various therapeutic options used to treat this disorder.
The literature was reviewed and the records of patients treated for the disorder were analyzed.
A convenient classification of the disorder divides cases into congenital and acquired. Therapy is primarily dependent on whether the disease is self-limited and whether there has been any pathological change in the skin, lymphatics and subcutaneous tissue. For self-limited diseases in which no permanent pathological sequelae occur conservative therapy is appropriate. For most chronic conditions a surgical procedure is required. Excisional techniques are most effective for severe forms of the disease. In select cases subcutaneous tissue excision with preservation of the overlying skin is appropriate. However, for most patients excision of the skin and subcutaneous tissue with split-thickness grafting is most effective.
When patients with lymphedema of the external genitalia require surgery and are properly selected for the appropriate procedure, the functional and cosmetic results are excellent and patient rehabilitation is likely.
本文提出一种外生殖器淋巴水肿的简单分类方法,这有助于选择合适的治疗方法,并评估我们使用各种治疗方案治疗该疾病的经验。
回顾文献并分析治疗该疾病患者的记录。
一种便捷的疾病分类将病例分为先天性和后天性。治疗主要取决于疾病是否为自限性以及皮肤、淋巴管和皮下组织是否有任何病理变化。对于无永久性病理后遗症的自限性疾病,保守治疗是合适的。对于大多数慢性疾病,需要进行外科手术。切除技术对严重形式的疾病最有效。在某些情况下,保留覆盖皮肤的皮下组织切除术是合适的。然而,对于大多数患者,切除皮肤和皮下组织并进行分层皮片移植最为有效。
当外生殖器淋巴水肿患者需要手术并被正确选择合适的手术方法时,功能和美容效果极佳,患者康复有望。