Husmann D A, McLorie G A, Churchill B M
University of Texas Southwestern Medical Center, Dallas.
J Urol. 1989 Aug;142(2 Pt 2):563-4; discussion 572. doi: 10.1016/s0022-5347(17)38816-x.
During the last 25 years 8 genotypic male subjects with cloacal exstrophy have undergone phallic reconstruction. All 8 patients had phallic inadequacy after completion of the reconstruction with penile lengths at or below 2 standard deviations below the mean. Of the patients 4 have reached puberty and 2 have documented physiological impotence by nocturnal penile tumescence testing. Three patients have required intensive psychiatric counseling, ranging from 18 months to 3 years because of feelings of sexual inadequacy. Of 2 patients who have attempted sexual relations 1 is unable to penetrate the vagina because of phallic size and 1 is presently engaged in successful vaginal intercourse. As a consequence of phallic inadequacy and its associated psychological trauma in these individuals we strongly recommend sexual conversion as part of the initial management plan.
在过去25年里，8名患有泄殖腔外翻的基因型男性患者接受了阴茎再造手术。所有8例患者在再造完成后阴茎长度均处于或低于均值2个标准差，存在阴茎发育不全的情况。其中4例患者已进入青春期，2例通过夜间阴茎勃起测试证实存在生理性阳痿。3例患者因性能力不足的感觉，需要接受18个月至3年不等的强化心理辅导。在2例尝试过性关系的患者中，1例因阴茎尺寸过小无法插入阴道，另1例目前阴道性交成功。鉴于这些患者存在阴茎发育不全及其相关的心理创伤，我们强烈建议将性别转换作为初始治疗计划的一部分。
