目的 解剖观察尸体阴茎筋膜结构，探索先天性隐匿阴茎病因，为预防术后阴茎回缩、包皮长期淋巴水肿及恢复阴茎正常外观提供理论依据。 方法 解剖10例成年男性尸体阴茎，观察阴茎体部各层筋膜结构特点。将解剖发现应用于先天性隐匿阴茎手术，观察记录60例患者术中及术后随访情况。结果 阴茎浅筋膜具有浅、深两个亚层，浅筋膜浅层富含血管、神经及淋巴组织，保持其完整可有效避免术后包皮长期淋巴水肿；阴茎浅筋膜深层是乏血供膜状组织，与浅筋膜浅层及深筋膜间均有大量融合纤维，其作用是将浅筋膜浅层锚定于深筋膜。手术切除该层组织后，患者阴茎正常伸出，术后随访无阴茎回缩病例。阴茎深筋膜将阴茎背动脉、背深静脉及阴茎背神经固定于白膜，术中损伤可能导致严重并发症。阴茎-阴阜/阴囊皮肤交界线和耻骨下/阴囊中隔脂肪平面是重建阴茎耻骨角及阴茎阴囊角解剖标记。 结论 阴茎体部各层筋膜解剖结构及功能各不相同。熟悉解剖结构对预防术后阴茎回缩、包皮长期淋巴水肿，恢复阴茎正常外观有重要意义。
Abstract
Objective To explore the etiology of congenital concealed penis and provide theoretical basis for preventing postoperative penile retraction, long-term lymphedema of prepuce by the anatomical observation of penile fasciae in cadavers. Methods Ten adult male cadaver penises were dissected to observe the structures of penile fasciae. The anatomical findings were applied to the surgery for correcting congenital concealed penis. The intraoperative and postoperative data of 60 patients were investigated and recorded. Results The dartos fascia has sub-layers. Many blood vessels, nerves, and lymphatic tissues were found in the superficial layer. The reserve of an intact superficial layer of dartos fascia during surgery will help prevent long-term lymphedema of prepuce. The deep layer of dartos fascia was a membranous tissue with fewer venules, and there were many fused fibers with the superficial layer of dartos fascia or Buck's fascia. The deep layer of dartos fascia was fixed to Buck's fascia by the fused fibers. After removing the deep layer of dartos fascia, the penis was extended obviously. None of the patients underwent postoperative penile retraction. The Buck's fascia fixed the dorsal artery, deep dorsal vein and dorsal nerves to tunica albuginea. The injury may lead to severe complications. The skin borderline between penile shaft and mons pubis or scrotum, as well as the fat plane of subpubic or scrotal septum, is an anatomical landmark for reconstructing the penoscrotal angle. Conclusions The anatomical structures and functions of penile fascia are different. It is important to have a good understanding of the anatomical structure to prevent the penis retraction after operation, long-term lymphedema of prepuce and restore the normal appearance of the penis.
关键词
隐匿阴茎 /
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阴茎筋膜 /
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应用解剖 /
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亚层
Key words
Concealed penis /
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Fascia /
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Applied anatomy /
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Sub layer
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