Wood Dan, Woodhouse Christopher
Adolescent Urology Department, University College London Hospitals.
ScientificWorldJournal. 2011 Mar 7;11:614-23. doi: 10.1100/tsw.2011.38.
This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism.
本文探讨了青少年男性阴茎异常的治疗及潜在病情的影响和结果。文中讨论了主要的先天性异常(如膀胱外翻/尿道上裂),包括心理影响、该群体中的常见问题(如阴茎体不对称、阴茎下弯和瘢痕形成)以及对潜在手术候选者的手术评估。新手术技术的出现持续改善治疗效果,并可能提高患者的期望。对于小阴茎等情况,进行平衡的讨论很重要,包括为患者提供多学科支持,这对于做出恰当的治疗决策至关重要。局部治疗可能有价值,但在极端情况下,阴茎成形术是患者可考虑的一个有价值的选择。对于埋藏阴茎,强调了仔细评估的重要性,并且对于大多数患者而言,手术应推迟到青春期结束后进行。在尿道下裂患者中,多种手术方法使治疗效果的评估变得复杂。由于许多早期接受手术的男性在青春期或成年期未接受重新评估,似乎真正的手术成功可能难以衡量。文中还简要讨论了后天性阴茎异常,包括淋巴水肿、阴茎骨折/创伤和阴茎异常勃起的病因及治疗。