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잠복음경 교정술: 기존 수술법을 보완한 방법 |
| 서울대학교 어린이병원 소아비뇨의학과 |
| 윤현식, 정혁달, 김승이, 정대혁, 한상헌, 임영재, 박관진 |
Introduction
In this video, we suggest a new modified surgical procedure for concealed penis repair.
Patients & methods
A 10-years-old patient is placed supine under general anesthesia. A dorsal longitudinal incision is made to slit the prepuce. A 2-0 polypropylene stay suture is placed through the glans for traction. The frenulum is incised. A Circumferential skin incision is made between two edges of the slit defect. The penile skin together with dartos fascia is completely degloved from the penile shaft down to the penopubic junction. And then, the penile skin is dissected from dartos fascia with care taken to avoid injuring the blood vessels on the skin. If the penis felt ticked into the scrotum, dartos mobilization should be extended into the deep scrotum. To facilitate dartos mobilization in deep scrotum ventral midline incision can be extended into in the deep scrotum which is not related to significant morbidity postoperatively. Dartos on the dorsal side separated from penile skin are incised to make two flaps. Two dartos flaps are relocated to the ventral side. And then, redundant dartos is cut off. Fixation of the relocated dartos is placed at Buck’s fascia of the corporeal body at 5 and 7 o’clock positions with 5-0 ethibond. After trimming of inner preputial skin, penile skin and incised frenulum are sutured with 6-0 vicryl. Usually tethered dartos fascia which makes outer penile skin contracted is isolated from preputial skin, ventral outer penile skin is sufficient or slightly deficient for full coverage of phallus. In this case, dorsal penile skin is transposed ventrally with Byars’s flap or buttonhole method.
Results
The total operation time was 50 minutes. The patient was discharged without any complications the day after the operation. There was no specific complication, such as penile edema, wound problem at postoperative day 11. The cosmetic outcomes were satisfactory and the patient parents’ satisfaction was very good.
Conclusions
Our modified surgical procedure could help reduce complications and relapse rates and provide good cosmetic outcomes.
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keywords : Concealed penis |
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