奇美醫院引進新技術包皮槍 為學童解決紅腫發炎與包莖問題!
2023-10-06 記者 蘇旋/報導
切除包皮有時機，包莖或反覆包皮炎較適合施作
一名國小五年級的陳小弟弟，因為包皮過長且常搔抓下體和跑廁所，由阿公帶來奇美醫院泌尿外科主治醫師蘇家震門診求診，身體檢查結果為反覆發炎感染導致，確立診斷為包皮紅腫發炎合併包莖。蘇醫師衛教阿公因陳小弟弟有包莖問題容易藏污納垢，所以要將包皮適當清洗乾淨，避免反覆發炎，並先開立抗生素和藥膏治療一週，之後再以包皮槍進行包皮環切手術，術後恢復良好，順利解決阿公及陳小弟弟的困擾。
奇美醫院泌尿外科主治醫師蘇家震表示，學童惱人包皮紅腫發炎合併包莖，小弟弟開雲見日，奇美醫院引進包皮槍，讓包皮不再搗蛋！
奇美醫療財團法人奇美醫院泌尿外科主治醫師蘇家震說明，包皮主要為保護龜頭及尿道開口，若過長加上無適當清潔，易引起細菌感染。大多數的初生男嬰都會有包皮過長狀況，隨著年齡的增長，包皮過長的情況也會逐漸下降，所以並非所有男性都要割包皮。根據奇美醫院2022年泌尿外科門診統計，共800位男性因包皮過長求診，其中以5歲至12歲(50%)的民眾最多，其次為13歲至25歲(30%)，執行包皮環切術的約100位。
奇美醫療財團法人奇美醫院泌尿外科主治醫師蘇家震指出，包皮過長常見的症狀有反覆性包皮龜頭炎、影響排尿、崁頓性包莖等，一般先從藥物及生活型態改變治療，若無達到治療效果的話，則可考慮使用手術方式處理。若幼兒及國小學童，曾發生包皮發炎兩次，或者發炎一次合併發燒，在控制感染後可考慮施行包皮環切術。青春期後和成人，若勃起時包皮過緊無法完整露出龜頭(包莖)，或者反覆包皮炎，則應割包皮一勞永逸。
一般割包皮採局部麻醉，若是小於9歲或怕痛的病人，亦可採靜脈麻醉，就不會感到不適。手術方式有「傳統包皮環切術」和最新的「一次性包皮切割吻合器(又稱包皮槍)」方式。
主治醫師蘇家震表示，隨著醫療技術進展，一次性包皮環切吻合器(又稱包皮槍)近年引進臺灣，奇美醫院自110年引進迄今，已完成300例。相較於傳統包皮環切術，一次性包皮環切吻合器手術時間僅需5至10分鐘，術中出血及術後疼痛也比較少、康復時間短，對於不希望長時間休息的病人更是一大優勢。不過，有些狀況像包皮嚴重沾黏的病人，就不適合使用包皮槍。而無論接受傳統手術或是包皮槍，術後包皮都有可能出現浮腫，故建議使用紗布及彈性繃帶覆蓋陰莖。保持傷口乾燥及局部清潔，若小便汙染敷料則需盡速更換，避免反覆發炎的情況發生。
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