Clinical study of concealed penis correction surgery based on principle of midline symmetry_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 JING Peng ¹ , ZOU Jiaqiong ² , ZHAO Dan ¹ , YANG Jinfeng ¹ , FENG Songlin ¹ , WANG Cheng ¹

1. Department of Pediatric Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan, 637000, P.R.China;
2. Department of Clinical Laboratory, the First Affiliated Hospital of Chengdu Medical College, Chengdu Sichuan, 610500, P.R.China;

Corresponding author：

JING Peng, Email: 820128944@qq.com

Keywords：

Concealed penis; principle of midline symmetry; correction surgery

DOI：

10.7507/1002-1892.201909106

Video：

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Objective To investigate the effectiveness of concealed penis correction surgery based on the principle of midline symmetry.Methods Between January 2016 and September 2018, 18 children with concealed penis were treated with correction surgery based on the principle of midline symmetry. All children were 3-12 years old, with an average age of 8.3 years. Physical examination showed that the penis was short; the penis body could not be exposed or be exposed too limited; the corpus cavernosum developed well. The pressure dressing was removed at 3 days after operation and the urethral tube was removed. The color of the glans, the swelling and congestion of penis and scrotum, and the blood supple of the prepuce flap were observed.Results The operation time ranged from 47 to 54 minutes, with an average of 50 minutes. All children were followed up 3 months after operation. There was no hemorrhage and necrosis of the glans and no infection or ischemic necrosis of the flap. All patients had different degree of prepuce edema at 3 days after operation, 5 patients still had prepuce edema at 2 weeks, and the prepuce edema in all patients subsided at 3 months. All penises were exposed well after midline symmetric anastomosis with no bulky prepuce and scrotum.Conclusion The correction surgery based on the principle of midline symmetry can be used to correct the appearance of the concealed penis effectively.

Citation： JING Peng, ZOU Jiaqiong, ZHAO Dan, YANG Jinfeng, FENG Songlin, WANG Cheng. Clinical study of concealed penis correction surgery based on principle of midline symmetry. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 505-508. doi: 10.7507/1002-1892.201909106 Copy

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2.	Shiraki IW, Shirai RS. Congenital micropenile skin sleeve. J Urol, 1975, 114(3): 469-472.
3.	Devine CJ. Concealed and webbed penis//Himan F. Atlas of pediatric urologic surgery. Philadelphia: Saunders, 1994: 608.
4.	Johnston JH. Concealed (beried) penis//Divid-Frank JV, Johnston JH. Opervtive pediatric urology. Edinburgh: Churchil Livingstone, 1990: 233-235.
5.	Brisson P, Patel H, Chan M, et al. Penoplasty for buried penis in children: report of 50 cases. J Pediatr Surg, 2001, 36(3): 421-425.
6.	阎景铁, 张大森, 李明伟. 改良 Devine 术+包皮远端皮瓣转移治疗小儿重度隐匿性阴茎的效果. 临床小儿外科杂志, 2017, 16(4): 406-408.
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8.	陈海琛, 吴永隆, 徐延波. 改良 Brisson 术治疗重度隐匿性阴茎疗效分析. 中国修复重建外科杂志, 2018, 32(12): 1581-1585.
9.	梁朝朝, 王克孝, 陈家应, 等. 合肥地区 5172 名男性青少年外生殖器疾病的流行病学调查. 中华医学杂志, 1997, 77(1): 15-17.
10.	Herndon CD, Casale AJ, Cain MP, et al. Long-term outcome of the surgical treatment of concealed penis. J Urol, 2003, 170(4 Pt 2): 1695-1697.
11.	Shaeer OK. Shaeer’s technique: a minimally invasive procedure for monsplasty and revealing the concealed penis. Plast Reconstr Surg Glob Open, 2016, 4(8): e1019.
12.	Anandan L, Mohammed A. Surgical management of buried penis in adults. Cent European J Urol, 2018, 71(3): 346-352.
13.	Srinivasan AK, Palmer LS, Palmer JS. Inconspicuous penis. Scientific World Journal, 2011, 11: 2559-2564.
14.	张华锋. 经阴茎腹侧阴囊衔接处楔形裁剪联合改良 Brisson 术治疗先天性隐匿阴茎. 中国修复重建外科杂志, 2013, 27(9): 1102-1105.
15.	王荣, 陈力, 王雪刚, 等. 改良阴茎脱套固定术治疗小儿隐匿阴茎85例报道. 临床泌尿外科杂志, 2012, 27(5): 387-388.
16.	Grossman JA. Cutaneous blood supply of the penis. Plast Reconstr Surg, 1989, 83(2): 213-216.
17.	白安胜, 宋江虹, 冯继周. 阴茎皮肤和包皮动脉的解剖及临床应用. 中国临床解剖学杂志, 2002, 20(1): 73-74.
18.	Mirastschijski U, Schwenke C, Melchior S, et al. Buried penis: A comprehensive review on aetiology, classification and plastic-surgical reconstruction. Handchir Mikrochir Plast Chir, 2017, 49(2): 78-84.

1. Maizels M, Zaontz M, Donovan J, et al. Surgical correction of the buried penis: description of a classification system and a technique to correct the disorder. J Urol, 1986, 136(1 Pt 2): 268-271.
2. Shiraki IW, Shirai RS. Congenital micropenile skin sleeve. J Urol, 1975, 114(3): 469-472.
3. Devine CJ. Concealed and webbed penis//Himan F. Atlas of pediatric urologic surgery. Philadelphia: Saunders, 1994: 608.
4. Johnston JH. Concealed (beried) penis//Divid-Frank JV, Johnston JH. Opervtive pediatric urology. Edinburgh: Churchil Livingstone, 1990: 233-235.
5. Brisson P, Patel H, Chan M, et al. Penoplasty for buried penis in children: report of 50 cases. J Pediatr Surg, 2001, 36(3): 421-425.
6. 阎景铁, 张大森, 李明伟. 改良 Devine 术+包皮远端皮瓣转移治疗小儿重度隐匿性阴茎的效果. 临床小儿外科杂志, 2017, 16(4): 406-408.
7. 范登信, 蔡盈, 曹永胜, 等. Shiraki-Devine 术治疗儿童隐匿阴茎的临床观察. 安徽医科大学学报, 2012, 47(8): 1005-1006.
8. 陈海琛, 吴永隆, 徐延波. 改良 Brisson 术治疗重度隐匿性阴茎疗效分析. 中国修复重建外科杂志, 2018, 32(12): 1581-1585.
9. 梁朝朝, 王克孝, 陈家应, 等. 合肥地区 5172 名男性青少年外生殖器疾病的流行病学调查. 中华医学杂志, 1997, 77(1): 15-17.
10. Herndon CD, Casale AJ, Cain MP, et al. Long-term outcome of the surgical treatment of concealed penis. J Urol, 2003, 170(4 Pt 2): 1695-1697.
11. Shaeer OK. Shaeer’s technique: a minimally invasive procedure for monsplasty and revealing the concealed penis. Plast Reconstr Surg Glob Open, 2016, 4(8): e1019.
12. Anandan L, Mohammed A. Surgical management of buried penis in adults. Cent European J Urol, 2018, 71(3): 346-352.
13. Srinivasan AK, Palmer LS, Palmer JS. Inconspicuous penis. Scientific World Journal, 2011, 11: 2559-2564.
14. 张华锋. 经阴茎腹侧阴囊衔接处楔形裁剪联合改良 Brisson 术治疗先天性隐匿阴茎. 中国修复重建外科杂志, 2013, 27(9): 1102-1105.
15. 王荣, 陈力, 王雪刚, 等. 改良阴茎脱套固定术治疗小儿隐匿阴茎85例报道. 临床泌尿外科杂志, 2012, 27(5): 387-388.
16. Grossman JA. Cutaneous blood supply of the penis. Plast Reconstr Surg, 1989, 83(2): 213-216.
17. 白安胜, 宋江虹, 冯继周. 阴茎皮肤和包皮动脉的解剖及临床应用. 中国临床解剖学杂志, 2002, 20(1): 73-74.
18. Mirastschijski U, Schwenke C, Melchior S, et al. Buried penis: A comprehensive review on aetiology, classification and plastic-surgical reconstruction. Handchir Mikrochir Plast Chir, 2017, 49(2): 78-84.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical study of concealed penis correction surgery based on principle of midline symmetry

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