The effect and comparative observation of the Z-shaped cross flap method on the ventral side of the penis and the transfer flap method on the dorsal side of the penis in pediatric phalloplasty
10.3760/cma.j.cn112330-20200221-00099
- VernacularTitle:阴茎腹侧Z形交叉皮瓣与阴茎背侧带蒂转移皮瓣在小儿阴茎成形术中的疗效比较
- Author:
Gang LI
;
Shuang LI
;
Jia YOU
;
Jun WANG
;
Haitao CHEN
;
Wei LEI
;
Haolun XU
;
Chunlei YANG
;
He XIAO
;
Yintao CHENG
- From:
Chinese Journal of Urology
2021;42(5):365-369
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effects of penile ventral Z-shaped cross flap and penile dorsal pedicled transfer flap in penoplasty for concealed penis.Methods:From January 2017 to June 2019, the data of 151 patients with concealed penis admitted to our hospital was retrospectively reviewed. The patients were divided into 2 groups according to the surgical method. 69 cases were treated with penis ventral Z-shaped cross flap to form penis and 82 cases were treated with dorsal penis pedicled flaps to form the penis. In Z-shaped flap group, the penis length of 33 patients with tight scrotum was (3.06±0.25)cm before surgery and the penis length of 36 patients with relaxed scrotum was (2.99±0.28) cm before surgery. In flap with transfer group, the penis length of 39 patients with tight scrotum was (3.04±0.30)cm before surgery and the penis of 43 patients with relaxed scrotum was (3.04±0.24)cm before surgery. The length of the penis after surgery and incidence of postoperative complications were compared between Z-shaped flap group and flap with transfer group. Common complications included penile body retraction, foreskin edema, foreskin stenosis and penile wound splitting.Results:151 patients were followed up for 6-12 months, and all patients were satisfied with penis appearance. There was no penile necrosis or urinary fistula. In Z-shaped flap cross group, the penis length of 33 patients with tight scrotum extended (2.47±0.22)cm after surgery.The penis length of 36 patients with scrotum relaxation extended (2.61±0.27)cm after surgery, 39 patients was adopted the penile dorsal pedicled transfer flap with scrotum tight had extended penis (2.90± 0.16)cm, which significantly different from the Z-shaped flap group( P<0.05). In flap with transfer group, 43 patients with relaxed scrotum extended (2.79±0.18)cm after surgery, which was significantly different from the Z-shaped flap group ( P<0.05). In Z-shaped flap group, 33 patients with scrotum tight, there were 2 cases of penile retraction, 1 case of stenosis of the foreskin, 2 cases of foreskin edema, 2 cases of penile wound rupture. In transfer flap group, of 39 patients with scrotum tight, there was 1 case of foreskin edema. The incidence of complications that adopted the penile dorsal pedicled transfer flap with scrotum tight was lower than those adopted penile ventral Z-shaped cross flap [2.56%(1/39) vs. 21.21%(7/33), P=0.033]. In transfer flap group, of the 43 patients with scrotum relaxation, there were 3 cases of penile retraction, 3 cases of foreskin stenosis, 2 cases of penile ventral foreskin edema, and 1 case of penile wound rupture. Z-shaped flap group: 36 patients was scrotum relaxation was 1 case of foreskin edema. The incidence of complications that adopted the penile dorsal pedicled transfer flap was higer than those adopted penile ventral Z-shaped flap [20.93%(9/43) vs. 2.78%(1/36), P =0.038]. Conclusions:In terms of children with tight scrotum or loose scrotum, the effect of the transfer flap method to extend the penis is better than that of the Z-shaped flap method. However, the transfer flap method has a low complication rate for children with tight scrotum, while the Z-shaped flap method has a low complication rate for children with loose scrotum.
