頁籤選單縮合
題 名 | Surgical Management of the Buried Penis=隱匿性陰莖的外科治療 |
---|---|
作 者 | 彭海祁; 陳厚全; 張伍泰; | 書刊名 | 中華醫學雜誌 |
卷 期 | 57:6 1996.06[民85.06] |
頁 次 | 頁424-430 |
分類號 | 417.5725 |
關鍵詞 | 隱匿性陰莖; Buried penis; |
語 文 | 英文(English) |
中文摘要 | 背景 隱匿性陰莖乃是有正常的陰莖長度,但外觀上卻很小甚至看不 見。這種疾病事實上並不稀少,但最近十年才有較多文獻的報告,為了瞭解其 致病機轉及追尋最好的手術方法,我們收集了最近6年本院手術的病童做一分 析。 方法 自1989年至1995年,6年期間共有31例孩童因隱匿性陰莖而接受手術, 依其主要致病機轉可分為三類;第一類主要是陰莖表皮鬆弛而沒粘連到恥骨上 深層肌膜,第二類主要是恥骨上脂肪堆積所引起,第三類主要是因一些不正常 的索狀纖維由陰莖軀幹連到腹壁所造成;我們依其分類再做分析。 結果 第一類有15位病童,大多數為嬰幼兒,手術方法以陰莖根部表皮固定 在恥骨上深層肌膜為主,手術簡單,效果良好。第二類有9例,都是小胖子, 年齡多大於9歲,手術方法必須多加上恥骨上脂肪切除,長期效果,只有5例 滿意。第三類有7位,必須游離索狀纖維,使陰莖外露,其中3位用內層包皮 覆蓋陰莖,均產生嚴重的水腫,其他4位沒有使用內層包皮,則效果良好。 結論 隱匿性陰莖產生的機轉主要有三種,這三種往往有或多或少的混合,因 而有不同的變異,治療方法應根據其病變的機轉而有所不同。而一般包皮環切 並不適合這類病童,對於肥胖的病人,減輕體重對長期的外觀可能相當重要; 對於粘連厲害,陰莖表皮不夠的病人,需要特殊的整型方法,才能得到好的結 果。 |
英文摘要 | Background. Buried penis is a congenital abnormality in which the phallus is concealed within the surface of prepubic skin. It is probably more common than is generally recognized. The objective was to describe the pathophysiology, and search for the best management of this disease. Methods. Over a period of 6 years, a total of 31 cases receiving surgery for buried penis at this hospital were analyzed. According to their major pathophysiology, patients were divided into three groups: in the first, the major mechanism was poor skin suspension; in the second, prominent suprapubic fat pad was the major cause. In the third group, the dartos fascia was abnormally thickened and attached to the penile shaft. Different surgical techniques were applied in the different groups. Results. All 15 children in the first group had satisfactory results after penile skin fixation. In the second group, nine children underwent adjunctive lipectomy but only five had satisfactory results. Seven patients in the third group needed degloving of the penis and the three cases who underwent preputial unfurling had severe lymphedema of the inner preputial layer. One of them received revision. The end results were good in the other six patients after long-term follow up. Conclusions. The buried penis occurs in a spectrum. Although, there are three major pathophysiology mechanisms, most of the patients had a combination. Surgical management should be individualized, and results are usually satisfactory . For the obese patient, weight loss is important. Preputial unfurling and using inner preputial layer to cover the defect should be avoided because of severe postoperative lymphedema. |
本系統中英文摘要資訊取自各篇刊載內容。