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阴茎切断术:美容及功能效果

Penile Amputation: Cosmetic and Functional Results.

作者信息

Virasoro Ramón, Tonkin Jeremy B, McCammon Kurt A, Jordan Gerald H

机构信息

Department of Urology, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health at Urology of Virginia, Eastern Virginia Medical School, Norfolk, VA, USA.

Department of Urology, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health at Urology of Virginia, Eastern Virginia Medical School, Norfolk, VA, USA.

出版信息

Sex Med Rev. 2015 Jul;3(3):214-222. doi: 10.1002/smrj.50. Epub 2015 Oct 8.

Abstract

INTRODUCTION

Penile amputation is a rare type of external genital trauma. It may arise from accidental trauma, assault or self-inflicted mutilation. As with all trauma, initial management focuses on assessment and resuscitation of the patient. When available, hypothermic preservation of the detached penis should be undertaken.

AIM

This review serves to compile the current available information on etiology and management of penile amputation injuries, with focus on functional and cosmetic results.

MAIN OUTCOME MEASURES

Main outcome measures were penile cosmetics, viability, and sensation; urethral patency and graft survival, functionality.

METHODS

A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), and abstracts from scientific meetings was performed from 1980-2013.

RESULTS

Due to the rarity of penile amputation injuries, no randomized trials exist. Likewise, available published series on management of this condition are comprised of a small number of patients.

CONCLUSIONS

Penile amputation is rare but challenging. Current microreplantation procedures have a uniformly good result with a minimum number of post-operative complications. When microreplantation cannot be performed, older corporal reattachment techniques may be offered. When phallic reconstruction is required, a microsurgical free forearm flap phalloplasty may be performed to restore the patient with an acceptable cosmetic and functional phallus. Virasoro R, Tonkin JB, McCammon KA, and Jordan GH. Penile amputation: Cosmetic and functional results. Sex Med Rev 2015;3:214-222.

摘要

引言

阴茎离断是一种罕见的外生殖器创伤类型。它可能由意外创伤、攻击或自残所致。与所有创伤一样,初始处理重点在于对患者的评估和复苏。如有可能,应进行离断阴茎的低温保存。

目的

本综述旨在汇总当前关于阴茎离断伤病因及处理的可用信息,重点关注功能和外观结果。

主要观察指标

主要观察指标为阴茎外观、存活情况和感觉;尿道通畅情况、移植物存活及功能。

方法

使用医学期刊数据库(Medline)、美国国立医学图书馆和美国国立卫生研究院的PubMed以及科学会议摘要进行文献检索,检索时间范围为1980年至2013年。

结果

由于阴茎离断伤罕见,不存在随机试验。同样,关于该病症处理的已发表系列研究均为少量患者。

结论

阴茎离断虽罕见但具有挑战性。当前的显微再植手术结果一致良好,术后并发症最少。若无法进行显微再植,可采用较陈旧的阴茎体重新附着技术。如需进行阴茎重建,可采用显微外科游离前臂皮瓣阴茎成形术,以使患者恢复外观和功能均可接受的阴茎。维拉斯罗·R、汤金·J·B、麦卡蒙·K·A及乔丹·G·H。阴茎离断:外观和功能结果。《性医学评论》2015年;3:214 - 222。

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