Department of Pediatric Surgery, West China Hospital of Sichuan University, Wai-nan Guo-xue Xiang 37#, Chengdu, Sichuan, 610041, PR China.
J Pediatr Surg. 2012 Dec;47(12):2289-93. doi: 10.1016/j.jpedsurg.2012.09.023.
To evaluate the effect of pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis.
We retrospectively reviewed 97 consecutive patients with completely concealed penis, which had been surgically corrected between November 2004 and January 2012. All patients were repaired using 2 surgical methods: 18 with Shiraki's operation and 79 with a technique of pedicled foreskin skin flap.
With 1 month to 7 years (mean 18 months) follow-up, the 18 cases treated by Shiraki's operation had satisfactory exposed penile shaft but too much incision and obvious edema. The 79 cases treated by pedicled foreskin skin flap uniformly reported satisfaction with the operative results. They found the surgical repair was successful in appearance and improved hygiene, accessibility, and penile exposure. There was no recurrence to the pre-treatment condition, or any chordee, penile distortion, trapped penis, erectile abnormalities, or voiding complications in any case. The pedicled skin flap was without ischemia or necrosis and yielded no post-operative wound infections, wound separation, or unsightly scarring. Slight edema and swelling of the flap were common, but these issues completely resolved by 3 weeks.
Numerous operative procedures have been described and adopted for the management of completely concealed penis, but the pedicled skin flap phalloplasty can achieve maximum utilization of prepuce to assure coverage of the exposed penile shaft. It has fewer complications, achieving marked aesthetics and often functional improvement. This suggests pedicled foreskin skin flap for phalloplasty is a relatively ideal means for treating completely concealed penis.
评估带蒂包皮皮瓣在完全埋藏阴茎成形术中的效果。
我们回顾性分析了 2004 年 11 月至 2012 年 1 月期间 97 例完全埋藏阴茎患者的临床资料。所有患者均采用 2 种手术方法修复：18 例行 Shiraki 手术，79 例行带蒂包皮皮瓣技术。
随访 1 个月至 7 年（平均 18 个月），18 例行 Shiraki 手术的患者阴茎干暴露满意，但切口过多，水肿明显。79 例行带蒂包皮皮瓣的患者对手术结果均满意。他们发现手术修复在外观和改善卫生、可及性和阴茎暴露方面均成功。无 1 例复发至治疗前状态，无阴茎下弯、阴茎扭曲、陷没阴茎、勃起异常或排尿并发症。带蒂皮瓣无缺血或坏死，无术后伤口感染、伤口分离或难看的瘢痕。皮瓣轻度水肿和肿胀很常见，但在 3 周内完全消退。
对于完全埋藏阴茎，已有多种手术方法被描述和采用，但带蒂皮瓣阴茎成形术可最大限度地利用包皮，确保覆盖暴露的阴茎干。它的并发症较少，可获得显著的美学效果，且常能改善功能。这表明带蒂包皮皮瓣是治疗完全埋藏阴茎的一种较为理想的方法。
