中文摘要：

目的：探讨严重阴茎病变（畸形）的外科治疗方法。方法：62例患者年龄19—63岁（平均35岁），其中阴茎部分缺失4例，分别行阴茎缺损修复、阴茎延长术、尿道成形术；阴茎完全缺失3例，行阴茎再造术；阴茎严重弯曲22例，行“16点”弯曲矫正术；阴茎折断15例，1例保守治疗，14例分别修补阴茎海绵体、尿道海绵体，阴茎背深静脉结扎；假体植入术后并发症5例，包括假体从尿道穿出、水泵失灵、连接管断裂，勃起角度〈60。和海绵体无法扩张，分别行假体取出、修补尿道裂口，更换新的假体，切除纤维化的瘢痕再次植入假体；阴茎完全离断4例，行阴茎再植术；撕脱伤3例，行皮瓣回植和游离植皮；阴茎Paget病6例，行病灶切除、游离植皮和阴茎埋入阴囊。结果：该组随访3个月至4年，平均9个月，4例阴茎部分缺失患者，2例术后阴茎外形满意，性功能恢复，较满意和不满意各1例。阴茎完全缺失3例术后外形满意，排尿好，1例不满意。22例阴茎严重弯曲均被矫正，1例复发。阴茎折断15例，失访1例，14例获得随访，性功能均恢复，术后并发症5例，分别为轻度弯曲、性交痛、皮下硬结、硬度差、性快感差，未作进一步处理。假体植入术后并发症5例，再次手术均成功，术后均能进行性生活，4例配偶满意，仅1例配偶不满意。阴茎完全离断4例，2例再植成功，2例坏死。撕脱伤3例植皮均获得成功。6例阴茎Paget病患者术后皮瓣均成活，随访2—4年，1例死于脑转移，5例无瘤存活至今。结论：该类病例需在泌尿男科手术的基础上，配合显微外科技术、皮瓣或皮肤移植技术等，设计个性化手术方案，能解决大多数患者的阴茎形态和勃起功能障碍，但部分患者仍不能达到理想的外形或功能，有待于寻求新的治疗方法。

英文摘要：

Objective ： To investigate the effects of surgery treatment on serious penile lesions and malformation. Methods ： Sixty-two patients, aged from 19 to 63 years old （mean 35 ys） , were included in the study. Among them, 4 patients suffered from penis partial defection were respectively treated with restoring defective penis, penis lengthening and urethroplasty; three patients with penis completely missing were treated with penis reconstruction surgery; 22 cases with serious penile curvature were treated with the 16-dot plieation technique （Lue＇s procedure） ; 15 cases with penile fracture were treated with conservative treatment for 1 case and with patch penis, corpus spongiosum, and deep penile dorsal vein ligation for lg cases ; 5 cases with post-operative complications of 3-pieces of penile prosthesis, including the prosthesis perforating to the urethra, water pump failure, broken connection tube, erection angle 〈 60 ° and failure to expansion the corpus cavernosum, were treated by taking out prostheses, urethral repair cracks, replacement of the prostheses, excision of fibrosis scar and re-implantation prostheses respectively. Four cases with penis complete amputation were treated with the penis replantation; three cases of avulsion injury were treated with the replantation and free flap skin; 6 with Paget＇s disease of penises were treated with the lesion free skin buried in the scrotum and penis. Results： All these patients were followed up for 3 months to 4 years, with the average of 9 months. Among the 4 cases of penis partial defection, 2 patients were satisfied with the penile appearance and sexual function; 1 got some satisfactory and 1 was unsatisfied. Three cases with the loss of the penis completely were satisfied with both the postoperative appearance and urination, and 1 was not satisfied. Twenty-two cases of penile curvature deformities were corrected, and one case was recurrence. Fourteen of the 15 patients with penile fracture were followed, and all got the restoration of sexua