周如意,陈军,阳晓林,潘泽意,黄明义,李中华

[摘要]目的：探讨隐匿性阴茎被误诊为包皮过长并行包皮环切术后的有效补救手术方法。方法：对21例隐匿性阴茎被误诊为包皮过长并行包皮环切术后的患者，采用改良的Devine术式矫治隐匿性阴茎和阴囊中隔带蒂皮瓣修复阴茎的皮肤缺损，观察其疗效。结果：21例患者阴茎外观均获恢复或接近正常，无一例出现皮瓣坏死，其中2例出现阴茎水肿，3月后恢复正常。随访1～2年无一例阴茎回缩，排尿勃起功能正常。结论：隐匿性阴茎误诊为包皮过长行包皮环切后，用改良的Devine术式治疗隐匿性阴茎和阴囊中隔带蒂皮瓣修复阴茎皮肤缺损是一种较好的手术补救方法。

[关键词]隐匿性阴茎；误诊误治；整形外科

[中图分类号]R697.11[文献标识码]A[文章编号]1008-6455（2012）04-0551-02

Correction for concealed penis after misdiagnosis and mistherapy

ZHOU Ru-yi, CHEN Jun, YANG Xiao-lin,PAN Ze-yi, HUANG Ming-yi,LI Zhong-hua

(Department of Urology Surgery, Second People's Hospital of Guangshui, Guangshui 432700, Hubei,China)

Abstract: ObjectiveTo study the effective correction for concealed penis after being misdiagnosed redundant prepuce and operated by circumcision.Methods21 concealed penis patients misdiagnosed redundant prepuce and operated by circumcision were corrected by improved Devine's operation through midline scrotal flap with vessel pedicle for defectofskin.ResultsShapes of 21 patients' penis were all recovered or nearly normal, and none appeared skin flap necrosis. Two cases appeared edeama of the penis, but recoverd after 3 month. The penises were all developed normal without problem of uresis and erectile function.ConclusionImproved Devine's operation for concealed penis associated with midline scrotal flap with vessel pedicle for defectofskin is a effective remediation for concealed penis after misdiagnosis and mistherapy.

Key words: concealed penis; misdiagnosis and mistherapy; orthopedic surgery

基层医疗机构外科医生在没认识到隐匿性阴茎的存在下，盲目地行包皮环切，会使隐匿性阴茎的治疗变得复杂，手术难度加大，再次手术时常伴有皮肤缺损。我院1999～2009年共收治此类患者21例，现将其误诊误治的原因和补救手术方法报道如下。

1资料和方法

1.1 一般资料：我院1999～2010年共收治21例隐匿性阴茎被误诊为包茎包皮过长而行包皮环切患者，年龄5～15岁，平均年龄9.5岁。其中来自基层医院15例，社区卫生服务站3例，妇幼保健机构2例，县级医院1例。检查均可见阴茎短小，自然状态包皮仍覆盖龟头，包皮与阴茎分离，牵拉龟头并按压阴茎根部皮肤，见阴茎发育基本正常，可伸出包皮外，但阴茎皮肤较紧张，停止牵拉和按压后阴茎迅速回缩，再次手术时间间隔6月～6年。……