Abstract: Objective　To explore the clinical effects of two kinds of modified phalloplasty in adolescent males with common external genital malformations. Methods　The clinical data of 77 adolescent males with common external genital malformations who underwent modified phalloplasty in The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University from January 2018 to March 2020 were retrospectively reviewed. Among them, 56 patients with redundant prepuce and phimosis were (17.8±2.3) years old, and 21 patients with concealed penis were (14.6±2.6) years old. The operative procedure, operative time, blood loss, postoperative complications, and follow-up were reviewed to summarize the application effect. Results　Fifty-six patients with redundant prepuce and phimosis underwent modified circumcision, and 21 patients with concealed penis underwent modified phalloplasty. The operation process of all patients was smooth. In 56 patients with redundant prepuce and phimosis, 4 patients had edema of varying degrees, which resolved spontaneously within 2 weeks. In 21 patients with concealed penis, 5 patients developed edema of varying degrees, which all resolved spontaneously within 3 weeks; 1 patient had postoperative retropubic infection, which improved within 1 week after active symptomatic treatment. After follow up of 6-12 months, the penises of both groups were well straightened and naturally esthetic in appearance, and the patients and their parents were satisfied. Conclusions　Both modified surgical methods have good surgical results and postoperative appearance. For patients with redundant prepuce and phimosis, modified circumcision has the advantages of less bleeding, lower cost, and aesthetic incision. For patients with concealed penis, the incision of modified phalloplasty is smaller, penile release is more adequate, and fixation is stronger. Besides, modified phalloplasty is not only suitable for pediatric patients with concealed penis, has a high application value in young patients.

Key words: Redundant prepuce, Concealed penis, Modified phalloplasty, Clinical effect

摘要： 目的　分析探讨2种改良阴茎成形术治疗青少年男性常见外生殖器畸形的临床效果。方法　选取2018年1月至2020年3月在南京医科大学附属常州第二人民医院接受改良阴茎成形术治疗的77例青少年男性外生殖器畸形患者，其中包皮过长及包茎患者56例，年龄（17.8±2.3）岁；隐匿阴茎患者21例，年龄（14.6±2.6）岁。回顾手术过程，记录手术时间、出血量，术后并发症及随访情况，总结应用效果。结果　56例包皮过长、包茎患者接受了改良包皮环切术，21例隐匿阴茎患者接受了改良阴茎成形术，所有患者手术过程顺利。包皮过长、包茎患者中4例出现不同程度水肿，在2周内自行消退。隐匿性阴茎患者中5例出现不同程度水肿，均在3周内自行消退；1例患者术后出现耻骨后感染，经积极对症治疗后在1周内好转。术后随访6～12个月，患者阴茎均伸直良好，外观自然美观，患者及家长均满意。结论　2种改良术式具有较好的手术效果及术后外观。对于包茎及包皮过长患者，改良包皮环切术具有出血少、费用低、切口美观的优点；而对于隐匿性阴茎患者，改良阴茎成形术的切口更小、阴茎松解更充分且固定更牢固。且改良阴茎成形术不仅适用于儿童隐匿性阴茎患者，在青年患者中同样具有较高的应用价值。

关键词: 包皮过长, 隐匿性阴茎, 改良阴茎成形术, 治疗效果