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目的:评估阴茎皮肤撕脱伤患者手术治疗后勃起功能的恢复情况。方法:回顾性分析我院2004～2009年经手术治疗的9例阴茎皮肤撕脱伤患者。吻合手术后,5例连通背深静脉、2条背动脉及至少2条背神经;2例仅连通2条背动脉及至少2条背神经;1例连接了单侧背动脉及同侧背神经;1例连接背深静脉及2条背神经。全部患者入院时均行国际勃起功能指数(IIEF-5)评分;随访时均接受化学假体及RigiScan阴茎硬度检测.并再次评定IIEF-5。结果:术后随访9～64个月。5例完全吻合患者中,1例RigiScan、化学假体检测及IIEF-5评分均提示勃起功能障碍,手术前后HEF-5评分无差异,其余4例阴茎勃起功能正常。2例仅吻合2条背动脉及背神经的患者术前IIEF-5评分1例正常.1例提示轻度勃起功能障碍.术后随访时HEF-5评分均正常。本组另2例患者术后随访时均提示有不同程度的勃起功能障碍,且随访时HEF-5评分均低于术前。结论:阴茎皮肤撕脱伤手术治疗时,血运的恢复状况可能是预测术后勃起功能的重要因素。
OBJECTIVE: To assess the recovery of erectile function after surgical treatment of penis skin avulsion. Methods: A retrospective analysis of 9 cases of penis skin avulsion in our hospital from 2004 to 2009 was retrospectively analyzed. After anastomosis, 5 cases had deep dorsal veins, 2 dorsal veins and at least 2 dorsal nerves. In 2 cases, only 2 dorsal veins and at least 2 dorsal nerves were connected. 1 case had unilateral dorsal artery and ipsilateral dorsal nerve 1 case connected with dorsal veins and 2 dorsal nerves. All patients were admitted to the International Erectile Dysfunction Index (IIEF-5) score; were followed up during the chemical prosthesis and RigiScan penile hardness test. And re-evaluation IIEF-5. Results: The patients were followed up for 9 to 64 months. In 5 patients with complete anastomosis, 1 case of RigiScan, chemical prosthesis test and IIEF-5 score all showed erectile dysfunction. There was no difference in HEF-5 score before and after operation, and the other 4 cases had normal erectile function. Two patients with only two dorsal arteries and two dorsal nerves had normal preoperative IIEF-5 score, and one had mild erectile dysfunction. HEF-5 scores were normal at follow-up. The other two patients in this group were followed up after surgery showed varying degrees of erectile dysfunction, and follow-up HEF-5 scores were lower than preoperative. Conclusion: The recovery of blood supply may be an important factor in predicting postoperative erectile function during surgical treatment of penis skin avulsion.