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阴茎皮肤撕脱伤:一种保守治疗方法

[Avulsion of the penile skin: a conservative approach].

作者信息

Negro C L A, Destefanis P, Bosio A, Bisconti A, De Maria C, Carchedi M, Buffardi A, Rolle L, Fontana D

出版信息

Urologia. 2010 Jan-Mar;77 Suppl 16:21-4.

Abstract

INTRODUCTION

Skin avulsion of male genital is a rare urological emergency. Although not life-threatening such lesions are both physically and psychologically traumatic. If poorly managed in the acute setting, these injuries may result in long-term problems or permanent disabilities.

METHODS

A 58 year-old male patient was admitted to the Emergency Department of our hospital with a traumatic injury of the penis, caused by a bike trauma. At the inspection, a rather complete degloving of penis and a tear in scrotal skin with no involvement of testes were observed. The skin was completely detached, out of the penis, but for a small flap at the peno-scrotal angle. After a careful cleaning, the penis was covered again with the skin attached to peno-scrotal angle through multiple circumferential sutures.

RESULTS

A complete cover of the defects was obtained with one-step surgery. The patient was treated with broad spectrum of antibiotics for 1 month. No infections occurred. The patient was discharged from hospital after 5 days. After 3 months from trauma, the patient is able to achieve sexual intercourse, with normal erectile function, no painful erections and no penile recurvatum.

CONCLUSIONS

Traumatic skin avulsion of penis is a rare condition; the best aesthetic and functional results depends on the choice of the proper treatment. Conservative approach in selected cases can provide good results both aesthetically and functionally.

摘要

引言

男性生殖器皮肤撕脱是一种罕见的泌尿外科急症。尽管此类损伤不会危及生命,但在生理和心理上都会造成创伤。如果在急性期处理不当,这些损伤可能会导致长期问题或永久性残疾。

方法

一名58岁男性患者因自行车外伤导致阴茎创伤,被送入我院急诊科。检查时发现阴茎皮肤几乎完全撕脱,阴囊皮肤有一处撕裂伤,睾丸未受累。皮肤已完全从阴茎上脱落,仅在阴茎阴囊角处有一小片皮瓣相连。仔细清洗后,通过多处环形缝合将与阴茎阴囊角相连的皮肤重新覆盖在阴茎上。

结果

一期手术成功完全覆盖了缺损部位。患者接受了1个月的广谱抗生素治疗,未发生感染。患者于5天后出院。受伤3个月后,患者能够进行性交,勃起功能正常,无疼痛性勃起,阴茎无下弯。

结论

阴茎创伤性皮肤撕脱是一种罕见病症;最佳的美学和功能效果取决于正确治疗方法的选择。在某些病例中采用保守治疗方法可在美学和功能方面均取得良好效果。

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