【摘要】 目的 探讨3T(Timing、Technique、Trade-off)原则在继发性阴茎畸形修复中的方法 及疗效。方法 对38例继发性阴茎畸形患者,按畸形情况分为:Ⅰ型14例,仅有阴茎皮肤缺损,但缺损横径及长度均超过阴茎周径及长度1/3,无法直接缝合者;Ⅱ型12例,阴茎大部分缺损畸形,残端长度>3.0锄者;Ⅲ型7例,阴茎大部分缺损畸形,阴茎残端长度<3.0 cm者;Ⅳ型5例,一侧阴茎海绵体和/或尿道海绵体坏死而导致复杂的阴茎畸形。按3T原则,选择不同的时间及方法 进行修复。结果 所有患者均获随访6个月至10年。Ⅰ型,阴茎皮肤缺损均获满意修复;Ⅱ型,术后阴茎形态接近正常,常态下长度为(6.8±1.2)cm,勃起后长度为(8.2±2.2)cm;Ⅲ型,术后阴茎常态下长度为(5.1±0.6)cm,勃起时长度为(6.5±0.9)cm,阴茎形态良好,再造阴茎头感觉于术后6个月开始逐渐恢复;Ⅳ型,术后均恢复正常阴茎外形,并能站立排尿。其中1例出现尿漏,经二次修复后治愈。结论 针对继发性阴茎畸形患者,根据畸形的类型不同,采用3T原则进行修复,能获得较好的治疗效果,值得临床推广应用。更多还原

【Abstract】 Objective To explore the clinical efficacy of 3T(Timing,Technique,Trade-off) principles in the reconstruction of secondary penile deformities.Methods From January 2005 until now,38 cases of secondary penile defects were treated with 3T principles based on different types of penile deformity:14 cases were with only penile skin defect as the type I,which the transverse diameter and length greater than 1/3 of the whole penis;12 were with large segment penile defects and the length of remnant penile more than 3.0 cm as the type Ⅱ;7 were with large segment penile defects and the length of remnant penile less than 3.0 cm as the type Ⅲ;5 were with complex penile deformities such as partial defects of unilateral corpora spongiosum penis and/or partial defect of corpora cavernosum urethrae as the type Ⅳ.Results All cases were followed-up from6 months to 10 years.The skin defects of Type Ⅰ were reconstructed with scrotal skin flap successfully.In type Ⅱ,the length of the remnant penis after operation were(6.8 ±1.2) cm at static state and(8.2 ±2.2) cm at erectile state respectively.In type Ⅲ,the length of the remnant penis after operation were(5.1 ±0.6) cm at static state and(6.5 ±0.9) cm at erectile state respectively.Sensation of scrotal flap which wrapped the penile shaft was all recovered at 6 months postoperatively.In type Ⅳ,normal urination and penile contour were achieved postoperatively except for one case with urinary fistula which was repaired by a secondary operation successfully.Conclusion 3T principles based on different type of penile deformities is useful in the reconstruction of penile defects with satisfactory results.It is worth of clinical application.更多还原