耻骨上吸脂术联合改良Devine术治疗成人获得性隐匿性阴茎

doi:10.19723/j.issn.1671-167X.2022.04.025

摘要/Abstract

摘要：

目的: 评价耻骨上吸脂术联合改良Devine术治疗因肥胖所致的成人隐匿性阴茎的安全性和有效性。方法: 回顾性分析北京大学人民医院泌尿外科及北京怡德医院外科于2017年9月至2020年6月收治的26例成人隐匿性阴茎患者的临床资料。患者平均年龄(33.0±5.7)岁，平均体重指数(body mass index，BMI)为(29.0±5.4) kg/m²，术前仰卧位非勃起状态下阴茎长度为(2.9±1.3) cm，所有患者均运用耻骨上吸脂术联合改良Devine术进行治疗。术后统计分析阴茎长度改善情况及并发症发生情况，随访患者的满意度(1分=不满意；2分=基本满意；3分=满意；4分=非常满意)。计量资料以均数±标准差($\bar x \pm s$) 表示, 数据比较采用非参数Friedman检验和多重分析方法。结果: 26例患者的平均吸脂量是(450.0±90.2) mL。术后即刻阴茎长度为(7.4±2.1) cm，较术前增加(4.5±1.6) cm；术后3个月阴茎长度为(5.3±1.8) cm，较术前增加(2.4±0.7) cm, 术前、术后即刻及术后三个月时的阴茎长度差异有统计学意义(P < 0.01)，所有患者术后均无性交障碍或排尿困难。术后出现水肿11例(42.3%)、皮下瘀斑7例(26.9%)、包皮伤口愈合不良2例(7.8%)、血肿1例(3.8%)，有5例(19.2%)患者术后未出现并发症，所有患者术后均无伤口感染。17例(65.4%)患者对术后阴茎外观和功能非常满意, 6例(23.1%)患者满意, 3例(11.5%)患者基本满意，无患者不满意，所有患者对术后阴茎外观和功能满意度评分为(3.5±0.7)分。结论: 使用耻骨上吸脂术联合改良Devine术治疗成人获得性隐匿性阴茎安全有效。

关键词: 阴茎延长, 吸脂术, 改良Devine术, 隐匿性阴茎, 成年人

Abstract:

Objective: To evaluate the safety and efficacy of suprapubic liposuction combined with modified Devine surgery in adult patients with concealed penis caused by obesity. Methods: The clinical data of 26 adult patients with buried penis admitted to the Department of Urology of Peking University People' s Hospital and the Department of Surgery of Beijing Eden Hospital from September 2017 to June 2020 were analyzed retrospectively. The average age of the patients was (33.0 ± 5.7) years, the average body mass index (BMI) was (29.0±5.4) kg/m², and the penis length in the supine position was (2.9±1.3) cm. All the patients were treated with suprapubic liposuction combined with modified Devine operation. The improvement of penis length and complications were statistically analyzed after operation, and the satisfaction of the patients was followed up, 1 = dissatisfied; 2 = basically satisfied; 3 = satisfied; 4 = very satisfied. The measurement data were expressed in (mean±SD), nonparametric Friedman tests and multiplex analysis methods were used for data comparison. Results: The average liposuction volume of the 26 patients was (450.0±90.2) mL. Immediately after operation: the penis length was (7.4±2.1) cm, increased by (4.5±1.6) cm compared with that before operation; three months after operation: the penis length was (5.3±1.8) cm, increased by (2.4±0.7) cm compared with that before operation. There was significant difference in penis length before operation, immediately after operation and three months after operation (P < 0.01). All the patients had no sexual intercourse disorder or dysuria. Postoperative edema occurred in 11 cases (42.3%), ecchymosis in 7 cases (26.9%), poor healing of prepuce wound in 2 cases (7.8%), hematoma in 1 case (3.8%), 5 cases (19.2%) without postoperative complications, and no patient had wound infection. Seventeen patients (65.4%) were very satisfied with the appearance and function of the penis, 6 patients (23.1%) were satisfied, 3 patients (11.5%) were basically satisfied, and no patients were dissatisfied. The average score of all the patients' satisfaction with postoperative penis appearance and function was (3.5±0.7). Conclusion: Suprapubic liposuction combined with modified Devine operation is safe and effective in the treatment of adult-acquired buried penis.

Key words: Penile lengthening, Liposuction, Devine' s technique, Buried penis, Adult

中图分类号:

R697.1

何海龙,李清,徐涛,张晓威. 耻骨上吸脂术联合改良Devine术治疗成人获得性隐匿性阴茎[J]. 北京大学学报（医学版）, 2022, 54(4): 741-745.

Hai-long HE,Qing LI,Tao XU,Xiao-wei ZHANG. Treatment of adult-acquired buried penis with suprapubic liposuction combined with modified Devine operation[J]. Journal of Peking University (Health Sciences), 2022, 54(4): 741-745.

图/表 3

图1

图2

图3

参考文献 23

1	应臣, 李超, 王继前, 等. 改良Devine术治疗隐匿性阴茎的临床分析[J]. 中外医疗, 2019, 38 (13): 88- 90.
2	樊胜海, 李学德. 隐匿阴茎研究进展[J]. 中华男科学杂志, 2015, 21 (9): 852- 854.
3	侯昱竹, 郭玺, 段燚星. 隐匿性阴茎的病因及治疗研究进展[J]. 山东医药, 2021, 61 (18): 98- 101. doi: 10.3969/j.issn.1002-266X.2021.18.025
4	Boonjindasup A , Pinsky M , Stewart C , et al. Management of adult concealed penis using a meshed, split-thickness skin graft[J]. Can Urol Assoc J, 2016, 10 (11/12): E407- E411.
5	Zhang X , Huang Z , Xiao Y , et al. Suspensory ligament release combined with acellular dermal matrix filler in infrapubic space: a new method for penile length augmentation[J]. Andrologia, 2019, 51 (9): e13351.
6	Fuller TW , Theisen KM , Shah A , et al. Surgical management of adult acquired buried penis[J]. Curr Urol Rep, 2018, 19 (3): 22. doi: 10.1007/s11934-018-0768-1
7	Jun MS , Gallegos MA , Santucci RA . Contemporary management of adult-acquired buried penis[J]. BJU Int, 2018, 122 (4): 713- 715. doi: 10.1111/bju.14230
8	Monn MF , Socas J , Mellon MJ . The use of full thickness skin graft phalloplasty during adult acquired buried penis repair[J]. Urology, 2019, 129, 223- 227. doi: 10.1016/j.urology.2019.04.007
9	Hughes DB , Perez E , Garcia RM , et al. Sexual and overall quality of life improvements after surgical correction of "buried penis"[J]. Ann Plast Surg, 2016, 76 (5): 532- 535. doi: 10.1097/SAP.0000000000000378
10	Rybak J , Larsen S , Yu M , et al. Single center outcomes after reconstructive surgical correction of adult acquired buried penis: measurements of erectile function, depression, and quality of life[J]. J Sex Med, 2014, 11 (4): 1086- 1091. doi: 10.1111/jsm.12417
11	田红娟, 唐达星, 杨荣旺. 性别发育异常性心理发育评估及价值研究进展[J]. 临床小儿外科杂志, 2019, 18 (3): 178- 183.
12	Shaeer O . Girth augmentation of the penis using flaps "Shaeer' s augmentation phalloplasty": the superficial circumflex iliac flap[J]. J Sex Med, 2014, 11 (7): 1856- 1862. doi: 10.1111/jsm.12537
13	高志翔, 刘晓龙. 隐匿阴茎的诊治进展[J]. 中国男科学杂志, 2021, 35 (1): 73- 75.
14	陈文军, 曹靖, 赵锦刚, 等. 成年男性隐匿阴茎诊治63例报告[J]. 中华男科学杂志, 2016, 22 (4): 361- 364.
15	Ghanem H , Elkhaiat YI , Motawi AT , et al. Infrapubic liposuction for penile length augmentation in patients with infrapubic adiposities[J]. Aesthetic Plast Surg, 2017, 41 (2): 441- 447. doi: 10.1007/s00266-017-0786-2
16	钟传华, 李文吉, 郭建华, 等. 经耻骨上"Ω"形切口脂肪切除术在成人肥胖型隐匿性阴茎患者阴茎矫正术中的应用[J]. 中华男科学杂志, 2021, 27 (10): 882- 885.
17	Illouz YG . Body contouring by lipolysis: a 5-year experience with over 3 000 cases[J]. Plast Reconstr Surg, 1983, 72 (5): 591- 597. doi: 10.1097/00006534-198311000-00001
18	Tausch TJ , Tachibana I , Siegel JA , et al. Classification system for individualized treatment of adult buried penis syndrome[J]. Plast Reconstr Surg, 2016, 138 (3): 703- 711. doi: 10.1097/PRS.0000000000002519
19	许晓文, 徐耀庭, 沈志杰, 等. Devine术加游离皮片移植治疗包皮缺损型隐匿性阴茎[J]. 中华男科学杂志, 2011, 17 (7): 625- 627.
20	Han DS , Jang H , Youn CS , et al. A new surgical technique for concealed penis using an advanced musculocutaneous scrotal flap[J]. BMC Urol, 2015, 15, 54. doi: 10.1186/s12894-015-0044-3
21	穆细院, 罗燕, 杨栋, 等. Devine术阴茎体固定于阴茎根部皮肤真皮层和耻骨筋膜治疗隐匿性阴茎的效果对比分析[J]. 当代医学, 2020, 26 (13): 130- 131.
22	Cui X, Gao BJ, Chen L, et al. A modified fixation technique for the treatment of buried penis in children[J/OL]. Asian J Androl, 2022, 5(2022-05-06)[2022-05-16]. https://pubmed.ncbi.nlm.nih.gov/35546287.
23	Ge W , Zhu X , Xu Y , et al. Therapeutic effects of modified Devine surgery for concealed penis in children[J]. Asian J Surg, 2019, 42 (1): 356- 361. doi: 10.1016/j.asjsur.2018.06.007

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

[1]	刘晓强,杨洋,周建锋,刘明月,谭建国. 成年人后牙失去邻牙合接触后的三维位置变化[J]. 北京大学学报（医学版）, 2021, 53(3): 594-597.
[2]	吴为良,曾筱,刘晓强,谭建国. 120例中国成年人上前牙美学比例分析[J]. 北京大学学报（医学版）, 2020, 52(6): 1130-1134.
[3]	唐顺, 郭卫, 杨荣利, 汤小东, 李大森, 董森. 40岁以上成年骨肉瘤患者的外科治疗及预后因素[J]. 北京大学学报（医学版）, 2015, 47(1): 165-169.
[4]	张崔建 , 李学松 , 虞巍 , 吴问汉, 何志嵩 , 金杰 , 周利群. 成人肾母细胞瘤的治疗及其长期随访结果[J]. 北京大学学报（医学版）, 2012, 44(4): 535-538.
[5]	关志忱, 魏本林, 孟作为. 远程无线排尿日记开发及20例年轻人客观排尿情况报告[J]. 北京大学学报（医学版）, 2010, 42(4): 476-479.
[6]	牟向东, 宿利, 聂立功, 那加, 王仁贵, 李海潮. 成人特发性肺含铁血黄素沉着症二例报道及文献回顾[J]. 北京大学学报（医学版）, 2008, 40(6): 595-599.
[7]	瓦斯里江·瓦哈甫, 何志嵩, 周利群. 成人肾母细胞瘤一例[J]. 北京大学学报（医学版）, 2008, 40(3): 334-338.
[8]	廖晓耘, 王颖, 骆丽, 姜宝玉, 虞有智, 回允中. 年轻胃癌患者临床病理分析及免疫组化研究[J]. 北京大学学报（医学版）, 2005, 37(5): 555-557.
[9]	李向东, 高雪梅, 曾祥龙. 83例无鼾男性上气道及周围组织的磁共振研究[J]. 北京大学学报（医学版）, 2005, 37(2): 190-194.