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外伤性阴茎离断的一期吻合术。

Primary anastomosis of the traumatically amputated penis.

作者信息

Salem H K, Mostafa T

机构信息

Department of Urology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt.

出版信息

Andrologia. 2009 Aug;41(4):264-7. doi: 10.1111/j.1439-0272.2009.00925.x.

Abstract

Penile amputation is an uncommon condition for which immediate surgical replantation is warranted. This work aimed to represent intervention and management for an amputated penis by replantation and reconstruction. A 23-year-old man presented with traumatic penile amputation for 2 h where the penile proximal part was 1 cm far from the pubis. Replantation included end-to-end anastomosis of the urethral mucosa over a catheter, approximation of the corpus cavernosum and tunica albuginea, anastomosis of the deep dorsal vein, dorsal nerve, both dorsal arteries and superficial dorsal vein. At day 5 post-operatively, the replanted penis had preserved capillary filling. The catheter was removed at day 11, where the patient urinated smoothly. The preliminary cosmetic appearance was satisfactory with frequent morning erection, reported night emission twice within the first month post-operatively. Sensation was preserved in the distal anastomosed stump. It is concluded that meticulous microsurgical technique decreases the possibility of skin loss and increases the chance of erectile function.

摘要

阴茎离断是一种罕见的情况,对此需要立即进行手术再植。这项工作旨在介绍通过再植和重建对离断阴茎的干预和处理。一名23岁男性因外伤性阴茎离断2小时就诊,阴茎近端距耻骨1厘米。再植包括在导尿管上进行尿道黏膜端端吻合、海绵体和白膜的对合、背深静脉、背神经、两条背动脉和背浅静脉的吻合。术后第5天,再植阴茎保留了毛细血管充盈。第11天拔除导尿管,患者排尿顺畅。初步外观满意,术后第一个月内晨勃频繁,报告有两次遗精。远端吻合残端感觉保留。结论是,精细的显微外科技术可降低皮肤丢失的可能性并增加勃起功能恢复的机会。

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