Excision of the deep layer of dartos fascia in the treatment of congenital severe concealed penis in children
10.3760/cma.j.cn114453-20240118-00027
- VernacularTitle:阴茎浅筋膜深层切除在儿童重度隐匿性阴茎手术中的应用
- Author:
Xing LI
1
;
Enmeng YUAN
;
Chaoyang HUA
;
Liangbin LI
;
Yanfang YANG
Author Information
1. 郑州大学附属儿童医院 河南省儿童医院 郑州儿童医院泌尿外科，郑州 450018
- Keywords:
Penis;
Severe concealed penis;
Dartos fascia;
Transfer of skin flap;
Child
- From:
Chinese Journal of Plastic Surgery
2024;40(7):765-770
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To present the experience of the anatomical of dartos fascia and describe a new technique for the correction of congenital severe concealed penis.Methods:This retrospective study was conducted on patients with congenital severe concealed penis who underwent surgery at Department of Urology, Children’s Hospital Affiliated with Zhengzhou University from January 2021 to December 2022. Reflex erection tests were routinely performed before surgery. The technique involved creating a median longitudinal incision combined with a curved incision of the ventral penile skin, dividing and excising the deep layer of dartos fascia, fixing the subcutaneous dermis at the pubic symphysis with sutures to the tunica albuginea of the penile root, and transferring the skin of the ventral root of the penis and scrotum to match the internal plate to cover the shaft of the penis. Follow-up of complications occurred after surgery, and the surgical effect was evaluated 6 months after surgery.Results:A total of 54 patients were enrolled, aged 2.8-10.0 years, with a median age of 6.7 years. In the presence of reflex erection, the penile skin was severely deficient in children with congenital severe concealed penis. The surgery was successfully completed, and the postoperative appearance was circumcised. In 43 cases with partial penile scrotal transposition, the transposition was corrected simultaneously. The incision healed well after surgery, with no infection or incisional dehiscence. Follow-up for 6 to 20 months, with an average of 12 months, showed mild edema of the prepuce in all children, which disappeared within 2 to 4 weeks after surgery. In 51 cases, the penis body showed good exposure, with no swelling of the penis skin and no retraction of the penis. The family members were satisfied with the appearance of the penis. The penis was partially retracted in 3 cases, that affected the appearance of the penis during the sitting position.Conclusion:In congenital severe concealed penis with severe skin deficiency, a deep dartos fascia was excised using a ventral median penile combined with a curved scrotal incision approach, and the penile root and scrotal skin covered the penile body with a circumcised appearance after surgery. The scrotal transposition of the penis was corrected at the same time to give the external genitalia an optimal appearance and provide good functional and cosmetic result.
