Stricture of the prostatomembranous urethra following pelvic fractures presents major problems in surgical management owing to their relatively inaccessible position above the urogenital diaphragm and behind the pubis. In 1973 Waterhouse and associates described transpubic approach to posterior urethral stricture, which has been usefully modified by Blandy as partial pubectomy for urethroplasty. Blandy`s method gives the extra room which needed to effect a tension-free anastomosis between bulbar and prostatic urethra and which was easily provided by taking away an arch of bone from the inferior of the symphysis. This method leaves pelvic ring intact, so avoids (a) subsequent pelvic instability and (b) the deformity that may result if an entire segment of symphysis is taken out and the penis falls into the defect. Our experience with 8 such cases has convinced us of the superiority of partial pubectomy for urethroplasty.
Congenital Abnormalities ; Constriction, Pathologic ; Diaphragm ; Male ; Penis ; Urethra ; Urethral Stricture

Penile fracture is an uncommon injury resulting from a direct blow to the erect penis. The authors experienced 6 cases of penile fracture recently and reviewed the literature. We performed immediate exploration with suture closure of the defect in all cases. None of the patients had penile deformity and all retained erectile potency. One of the two patients on whom primary end-to-end anastomosis was performed due to urethral rupture had mild urethral stricture. Therefore, we advocate early surgical repair of the penile fracture.
Congenital Abnormalities ; Humans ; Male ; Penis ; Rupture ; Sutures ; Urethral Stricture

Penile fracture is an uncommon injury resulting from a direct blow to the erect penis. The authors experienced 6 cases of penile fracture recently and reviewed the literature. We performed immediate exploration with suture closure of the defect in all cases. None of the patients had penile deformity and all retained erectile potency. One of the two patients on whom primary end-to-end anastomosis was performed due to urethral rupture had mild urethral stricture. Therefore, we advocate early surgical repair of the penile fracture.
Congenital Abnormalities ; Humans ; Male ; Penis ; Rupture ; Sutures ; Urethral Stricture

Inconspicuous penis is a group of symptoms that can make penis body not be showed normally instead of a kind of simple disease. They are presented with conclude concealed penis, buried penis, webbed penis and trapped penis. Most of them are resulting from congenital abnormality except the trapped penis. The diminutive penis caused by hypospadia and intersex and micropenis resulted from endocrine disease does not belong to this category. Pathological changes of concealed penis, buried penis and webbed penis are congenital but trapped penis is caused by acquired reasons. It's not difficult to make the diagnosis by the pathological and clinical manifestations. According to different age's indication, type and severity of the disease, corresponding surgery method ought to be chosen and the curative effect can be obtained.
Child ; Humans ; Male ; Penile Diseases ; congenital ; diagnosis ; therapy ; Penis ; abnormalities

Male ; Humans ; Consensus ; Genital Diseases, Male ; Penis/abnormalities*

OBJECTIVETo establish a stable rat experimental model of concealed penis for studying the effect of buried penis on the structure and function of the corpus cavernosum.

METHODSNinety male SD rats, aged 2 weeks, were randomly divided into 3 groups (A, B and C) of equal number. Groups A and B underwent surgery with intra-purse suture of the penile root and folding suture of the prepuce, respectively, to bury the penis, while Group C were included as sham operation controls.

RESULTSIn Group A, death resulted in 4 cases from acute post-operative urine retention, failure in burying the penis occurred in 5 cases because of soft tissue ulceration around the urethral orifice and in another 3 due to loose concealment. In Group B, 1 died from deep anesthesia and 2 from acute post-operative urine retention. With the penile development and erection, 7 in Group A and 10 in Group B protruded the penis in different stages. In Group C, 1 died from deep anesthesia. The operations succeeded in all the other rats in Groups A and B, with the success rates of 36.7% and 56.7%, respectively. And the concealment could be relieved any time during the experiment.

CONCLUSIONThe experimental rat model of concealed penis can be successfully established by both intra-purse suture of the penile root and folding suture of the prepuce, which is stable and similar to the natural course of this disorder in human.

Animals ; Disease Models, Animal ; Humans ; Male ; Penis ; abnormalities ; surgery ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Urogenital Abnormalities

OBJECTIVETo investigate the clinical effect of Devine's technique with free skin grafting in the treatment of concealed penis with prepuce deficit.

METHODSThis study included 7 children with concealed penis, aged 6 - 15 (mean 8.6) years, 6 of them treated by circumcision previously. All the patients underwent Devine's operation to resect the inelasticity sarcolemma and lengthen the penis. The length of prepuce deficit ranged from 2 to 4 cm. Intermediate split thickness skin grafts of the corresponding length were taken from the femoribus internus to wrap up the tunica albuginea penis, followed by the procedures of saturation, encapsulation and fixation.

RESULTSSurgery time ranged from 70 to 120 minutes, averaging 90.5 minutes. The penis was prolonged about 2 - 4 cm after surgery. A 6-month follow-up revealed desirable penile appearance and normal penile erection.

CONCLUSIONDevine's technique with free skin grafting from the femoribus internus is an ideal treatment for concealed penis with prepuce deficit.

Adolescent ; Child ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Skin Transplantation ; Surgery, Plastic ; methods ; Surgical Flaps

OBJECTIVETo evaluate some currently used surgical approaches to the correction of congenital penile curvature.

METHODSSeventy-six patients with congenital penile curvature underwent surgical correction, of whom 67 were accompanied with hypospadias, 5 with epispadias and 4 with normal urethral meatus. The methods for straightening the phallus included 5-week preoperative hCG treatment, complete degloving of penile skin, release of periurethral fibrous bands extending proximally to the meatus, plication of dorsal or ventral tunica albuginea, and embedding of dermis and tunica vaginalis grafts.

RESULTSAll the cases were followed up for 2 months to 2 years, and the mean follow-up time was 9.3 months. Satisfactory phallus straightening was achieved in 67 cases (88%), mild residual chordee remained in 6 (8%), which needed no reoperation for the time being unless warranted by follow-up, and relapse occurred in 3 (4%), which needed further operation.

CONCLUSIONMost cases of congenital penile curvature can be corrected sufficiently with the above methods.

Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Infant ; Male ; Penis ; abnormalities ; Urogenital Abnormalities ; surgery ; Urologic Surgical Procedures, Male ; methods

PURPOSE: Some patients still complain of a downward urine stream and a poor cosmetic result after the standard surgery, scrotoplasty because many patients with hypospadias basically have a low-set penis. We applied and evaluated a new concept for the surgery to improve the surgical results. MATERIALS AND METHODS: 22 patients underwent surgery for PST from January 1997 to June 2004. We performed transposition of penis in 7 patients, scrotoplasty in 13 and partial wedge resection of the scrotum in 2 who had the mild form of PST. Transposition of the penis is a surgical technique in which the skin of the penoscrotal junction is incised circumferentially and phallus is delivered into the buttonhole that is created in the normal anatomical position for the penis. We evaluated the cosmetic results using a satisfaction scoring system (1 to 5 scores) that was completed by the parents and the functional results by checking the angle of the urine stream in the standing position. RESULTS: There was no major complication for the 7 patients who underwent transposition of the penis. The mean satisfaction score was 4.6+/-0.8 and the angle of the urine stream was above 45 degrees in all patients. In the case of scrotoplasty, the mean satisfaction score was 3.6+/-0.9: half of them showed an angle of urine stream under 45 degrees and they complained of trouble when voiding. CONCLUSIONS: As the anatomical location of the penis, scrotoplasty is good for the normally positioned penis with PST, transposition of the penis for the low-set penis, and partial resection of the scrotal skin for the mild form. This individualized approach could improve the cosmetic and functional results for patients with PST.
Female ; Humans ; Hypospadias ; Male ; Parents ; Penis* ; Rivers ; Scrotum ; Skin ; Urogenital Abnormalities

Penile fracture is rather rare. Authors experienced two cases of penile fracture recently and reviewed the literature. Case 1 is a 34-year-old married male who visited our clinic on 17th Sept, 1976 with the chief complaint of painful swelling and deformity of the penis. The present illness started with a cracking sound followed with chief complaint on the day before his visit by sudden change of posture. Conservative treatment was done. After treatment no curvature nor deformity of the penis was found. After discharge the patient lives normal sexual life. Case 2 is a 59-year-old married male who visited our clinic on 8th April, 1977 with the chief complaint of urethral bleeding, painful swelling and deformity of the penis. He also experienced a cracking sound. Urethral catheter will not pass forward and urethrogram revealed extravasation of dye in the pendulous portion. Urethroplasty and Foley catheter indwelling were done. Urethrocutaneous fistula happened but no curvature was noticed.
Adult ; Catheters ; Congenital Abnormalities ; Fistula ; Hemorrhage ; Humans ; Male ; Middle Aged ; Penis ; Posture ; Urinary Catheters