Brisson P, Patel H, Chan M, Feins N
Department of Pediatric Surgery, Floating Hospital for Children, Boston, MA, USA.
J Pediatr Surg. 2001 Mar;36(3):421-5. doi: 10.1053/jpsu.2001.21605.
The authors report their experience with a large number of children with buried penis and describe their surgical technique.
Fifty consecutive cases of buried penis that occurred between 1993 and 1999 were analyzed by chart review. Age at the time of surgery was 11 months to 13 years. Each patient underwent elective surgical repair utilizing a surgical technique not described previously. The authors' technique avoids a circumferential incision at the base of the penis, decreasing postoperative edema. The authors also utilize a unique through and through vertical mattress suture at the base of the penis that firmly attaches the shaft skin to the underlying corpora.
All patients had a good to excellent outcome with a low postoperative complication rate. One patient fell during the postoperative period and developed a wound dehiscence. Early in the series 3 patients underwent additional procedures for recurrent retraction (6%). All patients experienced some postoperative discomfort as expected. Edema, when present, was mild and resolved within an acceptable period of time. All patients had a good cosmetic result with increased visualization of the penile shaft.
A surgical approach to the buried penis is warranted in most circumstances. There are psychological benefits to both the patients and the parents. Although the authors perform the procedure as early as 11 months, it can be performed safely at 3 months. The procedure reported here provides immediate excellent cosmetic results with a low complication rate. The authors do not recommend suprapubic lipectomy either alone or in combination with the buried penis procedure. Circumcision should be avoided in an infant with a definite diagnosis of buried penis.
作者报告他们大量隐匿阴茎患儿的治疗经验并描述其手术技术。
通过查阅病历分析1993年至1999年间连续收治的50例隐匿阴茎病例。手术时年龄为11个月至13岁。每位患者均采用一种此前未描述过的手术技术进行择期手术修复。作者的技术避免在阴茎根部做环形切口，减少术后水肿。作者还在阴茎根部采用独特的贯穿垂直褥式缝合，将阴茎皮肤牢固地附着于其下方的海绵体。
所有患者预后良好至极佳，术后并发症发生率低。1例患者术后摔倒，伤口裂开。在该系列早期，3例患者因复发回缩接受了额外手术（6%）。所有患者如预期经历了一些术后不适。水肿若出现则较轻，并在可接受时间内消退。所有患者外观改善良好，阴茎体显露增加。
在大多数情况下，隐匿阴茎的手术治疗是必要的。对患者及其父母都有心理益处。虽然作者最早在11个月时进行该手术，但3个月时也可安全进行。本文报道的手术能立即获得极佳的外观效果且并发症发生率低。作者不推荐单独或联合隐匿阴茎手术进行耻骨上脂肪切除术。对于确诊为隐匿阴茎的婴儿应避免行包皮环切术。
