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双V阴囊成形术修复先天性阴茎阴囊蹼状粘连:一种隐蔽瘢痕技术。

Double-V scrotoplasty for repair of congenital penoscrotal webbing: a hidden scar technique.

作者信息

McLeod Daryl J, Alpert Seth A

机构信息

Division of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA.

Division of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA; The Ohio State University Medical Center, Columbus, OH, USA.

出版信息

J Pediatr Urol. 2014 Oct;10(5):810-4. doi: 10.1016/j.jpurol.2014.01.014. Epub 2014 Feb 13.

Abstract

OBJECTIVE

Penoscrotal webbing (PSW) is a common reason for deferral of neonatal circumcision. Reports of successful procedures and outcomes in the literature are sparse. We have performed double-V scrotoplasty (DVS), a modification of a V-Y technique, in 138 patients with excellent results.

PATIENTS AND METHODS

We retrospectively reviewed the charts of boys who had undergone DVS for PSW since January 2009 by a single surgeon (S.A.A.). The indications, intraoperative findings, concomitant procedures, outcomes, and complications were recorded.

RESULTS

A total of 138 DVSs were performed. Concomitant genital surgeries included 81 hidden penis repairs and 10 other (hernia, hypospadias, chordee, orchidopexy). The median age at the time of surgery was 9.6 months (6.1 months-9.8 years). Patients were evaluated about 1 month postoperatively. In seven cases (5%), minor skin separation occurred at the penoscrotal junction but all healed completely. Superficial skin infection occurred in one patient. None required reoperation and cosmetic results were subjectively excellent.

CONCLUSIONS

PSW has been corrected in 138 patients without significant complications and with excellent results. This is the largest known peer-reviewed series evaluating a surgical technique for congenital PSW repair. We believe our technique is simple, reproducible, and, with no diverging suture lines lateral to the median raphe, improves cosmesis.

摘要

目的

阴茎阴囊蹼(PSW)是新生儿包皮环切术延迟的常见原因。文献中关于成功手术及结果的报道较少。我们对138例患者实施了双V阴囊成形术(DVS),这是一种改良的V-Y技术,效果极佳。

患者与方法

我们回顾性分析了自2009年1月起由单一外科医生(S.A.A.)为阴茎阴囊蹼患者实施双V阴囊成形术的男孩病历。记录手术指征、术中发现、同期手术、结果及并发症。

结果

共实施了138例双V阴囊成形术。同期生殖器手术包括81例隐匿阴茎修复术和10例其他手术(疝气、尿道下裂、阴茎硬结症、睾丸固定术)。手术时的中位年龄为9.6个月(6.1个月至9.8岁)。术后约1个月对患者进行评估。7例(5%)在阴茎阴囊交界处出现轻微皮肤分离,但均完全愈合。1例患者发生浅表皮肤感染。无一例需要再次手术,主观上美容效果极佳。

结论

138例阴茎阴囊蹼患者已得到矫正,无明显并发症,效果极佳。这是已知最大的经同行评审的评估先天性阴茎阴囊蹼修复手术技术的系列研究。我们认为我们的技术简单、可重复,且在正中缝外侧没有发散的缝线,改善了美容效果。

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