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目的总结5例阴茎完全离断再植的临床治疗及疗效。方法1990-06-2009-10对5例阴茎完全离断的患者,采用急诊在放大16倍的手术显微镜下按导尿管固定、吻合阴茎背静脉、阴茎背动脉及阴茎背神经的再植顺序。其中1例阴茎连同两侧睾丸离断,吻合输精管及血管。结果本组5例阴茎全部成活,其中1例阴茎连同两侧睾丸离断的患者,一侧睾丸及部分阴囊皮肤坏死,二期行大腿内侧局部转移皮瓣修复后愈合。2例阴茎皮肤部分坏死,换药后瘢痕愈合。术后随访时间为10个月~18 a。再植阴茎无明显尿道狭窄,皮肤感觉恢复良好,阴茎勃起功能恢复良好能完成正常的性生活。结论应用显微外科技术可明显提高阴茎离断再植的成活率,并可恢复阴茎的完整外形和良好的功能。
Objective To summarize the clinical treatment and curative effect of 5 cases of completely replanted penis. Methods From June 1990 to June 2009, 5 patients with complete penile fracture were treated with emergency catheterization under a microscope with a magnification of 16 times. The catheter was fixed and matched with the replantation of penis dorsal vein, penile dorsal artery and dorsal penile nerve . One case of the penis along with both sides of the testes off, consistent with vas deferens and blood vessels. Results All 5 cases of penis survived, including 1 case of penis with testicular severing on both sides of the testis and some scrotal skin necrosis, and 2 cases of local thigh flap metastasis healing. 2 cases of penile skin necrosis, dressing healing after the scar. The follow-up time ranged from 10 months to 18 years. Reproductive penis without significant urethral stricture, the skin feel good recovery, erectile function recovered well to complete normal sex life. Conclusion The application of microsurgical techniques can significantly improve the survival rate of penile replantation, and restore the intact penis shape and good function.