莫把严重的尿道下裂当成石女 Don't treat a severe hypospadias like a stone girl.转载2008-06-01

最近我在临床上见到几个石女，都是误诊误治的结果，原本都是隐睾并发严重尿道下裂，被父母当成女孩养，后来又被医生切除了隐睾，变成了“阴阳仙”。好在这些人的社会心理都是女性的，可以通过双膜阴道成型再塑女儿身，通过持续的雌激素替代治疗，能够使她们融入社会和家庭。如果是男性心理恐怕麻烦就大了。

Recently, I saw several stone women in clinical practice. They were all misdiagnosed and misdiagnosed. They were originally cryptorchidism and severe hypospadias. They were raised by their parents as girls. Later, they were removed by doctors and became "yin and Yang. Immortals." Fortunately, the social and psychological nature of these people is female. They can be re-molded through double-membrane vaginal formation, and they can be integrated into society and their families through continuous estrogen replacement therapy. If it's male, I'm afraid it's a problem.

尿道下裂是男性泌尿生殖系最常见的先天畸形，其他类型都容易确诊，只有会阴型并发隐睾：尿道外口位于会阴，外生殖器发育极差，阴茎短小而严重下曲，阴囊对裂，形如女性外阴，有时误作女孩抚养。甚至被误诊医生实施皮瓣阴道成型术，把外阴整的丑陋而无用。

Hypospadias is the most common congenital malformation in the male genitourinary system. Other types are easily diagnosed. Only the perineal type is accompanied by cryptorchidism: the outer mouth of the urethra is located in the perineum, the external genital development is extremely poor, and the penis is short and severe. The scrotum is split, shaped like a female vulva, Sometimes mistaken for a girl's upbringing. Even was misdiagnosed by the doctor to perform vaginal flap molding, the vulva is ugly and useless.

外阴畸形的患者最好是结合染色体和性腺扫描，一般不会误诊，绝不能单纯依靠外阴形态或经验，更不能随便手术切除隐睾等性腺。

Genital malformation patients are best combined with chromosome and gonad scanning, generally will not be misdiagnosed, must not rely solely on genital morphology or experience, and can not easily surgical removal of hidden testis and other gonads.

尿道下裂必须手术矫正。手术目的：第一，纠正下屈畸形，需切除阴茎腹侧纤维素，完全伸直阴茎。第二、尿道成形并使其开口位置尽可能接近正常。第三，是复位睾丸或阴囊成型。

Hypospadias must be surgically corrected. Purpose of operation: First, correct the deformity of the lower buckling, need to remove the ventral cellulose of the penis, completely straighten the penis. Second, the urethra is formed and its opening position is as close to normal as possible. The third is to reset the testicle or scrotum formation.

手术指征：除冠状沟型尿道下裂可作可不作手术外，其余各型必须颈手术纠正。

Indications of surgery: Except for the coronal groove type hypospadias can be used for surgery, the rest of the types must be corrected by neck surgery.

手术方法：据统计手术方法在150种以上。应根据手术者的枝术，患者的年龄和阴茎发育情况区别对待。一般说来，在幼年即完成治疗，可消除患者的心理影响，但年龄越小越不合作，加之阴茎小，操作困难，故手术失败的机率增加。因此有人主张分期手术，即在幼时先切除纤维索，纠正下屈畸形、待阴茎发育后再行II期尿道成形术。

Surgical methods: According to statistics, there are more than 150 surgical methods. The patient's age and penis development should be treated differently according to the operation of the surgeon. In general, the completion of treatment at an early age can eliminate the psychological impact of the patient, but the younger the age, the more uncooperative, and the smaller the penis, the more difficult the operation, so the chance of surgical failure increases. Therefore, some people advocate staged surgery, that is, the fiber cord is removed first when young, the deformity is corrected, and after the development of the penis, urethral plasty is performed during the second stage.