Shen Y D, Zhu L F, Tao C, Ru W, Zhao Y J, Wang Z, Yang F, Tang D X, He Y, Wang X P
Department of Pediatric Urology surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China.
Department of Urology surgery, Affiliated Hospital of Jiaxing University, Jiaxing 314000, China.
Zhonghua Yi Xue Za Zhi. 2020 Jun 9;100(22):1704-1707. doi: 10.3760/cma.j.cn112137-20190910-02001.
To investigate the therapeutic effect of simple tunica albugineaincision and ventral penile lengthening surgery on the correction of penile curvature due to asymmetry of the cavernous bodies in hypospadias. A retrospective analysis was performed in 39 children with hypospadias who underwent simple tunica albuginea incision and ventral penile lengthening surgery for correcting asymmetry of the cavernous bodies from January 2016 to December 2018(36 of them were from Department of Pediatric Urology surgery, The Children's Hospital, Zhejiang University School of Medicine, and 3 from Department of Urology surgery, Affiliated Hospital ofJiaxing University), all of whom aged from 0.5 to 5, with a median age of 1.1 years. During the first stage of the operation, firstly penile skin and sarcoma was released by completely degloving the skin and fascia of penis, secondly the factor of short urethral plate was solved by transection of urethral plate, and then the dorsal length of penis (A), the ventral length of the penis before and after straightening by incision of tunica albuginea (B and C) were measured and recorded; onto the second stage of the operation, an artificial erection test was performed to observe the curvature of the penis, the dorsal and ventral length of the penis (D and E) were measured. The dorsal and ventral length of the penis before and after straightening were compared. The dorsal length of penis (A) was 33-39(35.6±3.2) mm, the length of ventral length of penis before straightening (B) was 28-35 (29.8±2.8) mm and the length of ventral length of penis after straightening (C) was 32-38 (34.3±2.1) mm, which were measured during the first stage of operation, and the difference between B and C was statistically significant (<0.05), while the difference between A and C was not statistically significant (>0.05). The dorsal length of penis (D) was34-41 (36.4±2.5) mm and the ventral length of penis (E) was 33-40 (35.7±3.6) mm, which were measured during the second stage of operation, and there was no significant difference between D and E (>0.05). The degree of penile curvature at the time of erection was less than 15° by measuring with the side photos in all patients during 0.5 to 2.5 years of follow-ups with an average of 1.7 years. Penile curvature due to the asymmetry of the cavernous bodies could be effectively corrected by simple incision of ventral tunica albuginea, which showed a good result of early follow-up. The effect of this surgery on ventral penile straightening could be verified by measuring and comparing the ventral and dorsal length of penis during surgery.
探讨单纯白膜切开及阴茎腹侧延长术治疗尿道下裂海绵体不对称所致阴茎弯曲的疗效。回顾性分析2016年1月至2018年12月期间39例因海绵体不对称行单纯白膜切开及阴茎腹侧延长术矫正阴茎弯曲的尿道下裂患儿(其中36例来自浙江大学医学院附属儿童医院小儿泌尿外科,3例来自嘉兴学院附属医院泌尿外科),年龄0.5至5岁,中位年龄1.1岁。手术第一阶段,先通过完全游离阴茎皮肤和筋膜松解阴茎皮肤及肉瘤,再通过横断尿道板解决尿道板短的因素,然后测量并记录阴茎背侧长度(A)、白膜切开矫正前后阴茎腹侧长度(B和C);进入手术第二阶段,进行人工勃起试验观察阴茎弯曲情况,测量阴茎背侧和腹侧长度(D和E)。比较矫正前后阴茎背侧和腹侧长度。手术第一阶段测量阴茎背侧长度(A)为33 - 39(35.6±3.2)mm,矫正前阴茎腹侧长度(B)为28 - 35(29.8±2.8)mm,矫正后阴茎腹侧长度(C)为32 - 38(34.3±2.1)mm,B与C之间差异有统计学意义(<0.05),而A与C之间差异无统计学意义(>0.05)。手术第二阶段测量阴茎背侧长度(D)为34 - 41(36.4±2.5)mm,阴茎腹侧长度(E)为33 - 40(35.7±3.6)mm,D与E之间无显著差异(>0.05)。在平均1.7年、0.5至2.5年的随访期间,通过测量所有患者勃起时的侧面照片,阴茎弯曲角度均小于15°。单纯阴茎腹侧白膜切开可有效矫正海绵体不对称所致阴茎弯曲,早期随访效果良好。术中测量并比较阴茎腹侧和背侧长度可验证该手术对阴茎腹侧伸直的效果。