Surgical approach to concealed penis: Technical refinements and outcome

被引:68
作者
Borsellino, A.
Spagnoli, A.
Vallasciani, S.
Martin, L.
Ferro, F.
机构
[1] Bambino Gesu Pediat Hosp, Androl Surg Unit, Dept Nephrol & Urol, I-00165 Rome, Italy
[2] Bambino Gesu Pediat Hosp, Dept Anaesthesia & Intens Care, I-00165 Rome, Italy
关键词
D O I
10.1016/j.urology.2007.01.065
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives A concealed penis is defined as a phallus of normal size buried in prepubic tissue (buried penis), enclosed in scrotal tissue (webbed penis), or trapped by scar tissue after penile surgery (trapped penis). We report Our results using a standardized surgical approach that was highly effective in both functional and cosmetic terms. Methods From January 2002 to December 2005, 56 patients (median age 7 years) underwent surgery for a buried penis, 11 (median age 5 years) for a webbed penis, and 20 (median age 8 years) for a trapped penis. All 20 patients with a trapped penis had previously undergone circumcision for phimosis, except for 3 (1 for multioperated lymphangioma, 1 for repaired hypospadias, and 1 for corrected glanular epispadia). All webbed penises were phimotic, requiring circumcision. The Surgical technique consisted of complete exteriorization of the shaft and reconstruction of the penopubic and penoscrotal angles. These maneuvers, however, proved extremely straightforward, with the addition of an incision along the scrotal raphe without any incision of the penile skin. Results All the patients were observed for at least 1 year after repair. Recurrence was observed in 3 boys with a buried penis (5.3%); all 3 boys were obese. Two cases of a trapped penis (10.0%) recurred, but no case of a webbed penis recurred. Regarding complications, 2 patients with a buried penis presented with mild lymphatic stasis of distal shaft that spontaneously subsided within a few months. Conclusions The scrotal approach we have described has simplified the complete exteriorization of the penile shaft, with easy bleeding control, avoiding the use of flaps, grafts, and additional ventral Z-plasty often described in published reports. In addition, the cosmetic results were judged to be good by the parents.
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页码:1195 / 1198
页数:4
相关论文
共 12 条
[1]   Concealed penis in childhood: A spectrum of etiology and treatment [J].
Casale, AJ ;
Beck, SD ;
Cain, MP ;
Adams, MC ;
Rink, RC .
JOURNAL OF UROLOGY, 1999, 162 (03) :1165-1168
[2]   Anatomical alignment for the correction of buried penis [J].
Cromie, WJ ;
Ritchey, ML ;
Smith, RC ;
Zagaja, GP .
JOURNAL OF UROLOGY, 1998, 160 (04) :1482-1484
[3]   PREPUTIAL UNFURLING TO CORRECT THE BURIED PENIS [J].
DONAHOE, PK ;
KEATING, MA .
JOURNAL OF PEDIATRIC SURGERY, 1986, 21 (12) :1055-1057
[4]   A salvage surgical solution for recurrent lymphangioma of the prepuce [J].
Ferro, F ;
Spagnoli, A ;
Villa, M ;
Papendieck, CM .
BRITISH JOURNAL OF PLASTIC SURGERY, 2005, 58 (01) :97-99
[5]   Results of a simplified technique for buried penis repair [J].
Frenkl, TL ;
Agarwal, S ;
Caldamone, AA .
JOURNAL OF UROLOGY, 2004, 171 (02) :826-828
[6]   Split-thickness skin graft for the management of concealed penis [J].
Gillett, MD ;
Rathbun, SR ;
Husmann, DA ;
Clay, RP ;
Kramer, SA .
JOURNAL OF UROLOGY, 2005, 173 (02) :579-582
[7]   Long-term outcome of the surgical treatment of concealed penis [J].
Herndon, CDA ;
Casale, AJ ;
Cain, MP ;
Rink, RC .
JOURNAL OF UROLOGY, 2003, 170 (04) :1695-1697
[8]   HIDDEN PENIS RELEASE - ADJUNCTIVE SUPRAPUBIC LIPECTOMY [J].
HORTON, CE ;
VORSTMAN, B ;
TEASLEY, D ;
WINSLOW, B .
ANNALS OF PLASTIC SURGERY, 1987, 19 (02) :131-134
[9]   SURGICAL-CORRECTION OF THE BURIED PENIS - DESCRIPTION OF A CLASSIFICATION-SYSTEM AND A TECHNIQUE TO CORRECT THE DISORDER [J].
MAIZELS, M ;
ZAONTZ, M ;
DONOVAN, J ;
BUSHNICK, PN ;
FIRLIT, CF .
JOURNAL OF UROLOGY, 1986, 136 (01) :268-271
[10]   PENOPLASTY FOR BURIED PENIS SECONDARY TO RADICAL CIRCUMCISION [J].
RADHAKRISHNAN, J ;
REYES, HM .
JOURNAL OF PEDIATRIC SURGERY, 1984, 19 (06) :629-631