Department of Urology, Chongqing Children's Hospital, Chongqing Medical University, Chongqing, China.
BJU Int. 2013 Jul;112(2):271-5. doi: 10.1111/j.1464-410X.2012.11719.x. Epub 2013 Jan 29.
WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Surgical correction of the congenital completely buried penis (CCBP) is a difficult challenge and there is no unanimous consensus about the surgical 'gold standard' and patient eligibility for surgery. In the present study, dysgenetic fundiform ligaments were found to be attached to the distal or middle shaft of the penis. This abnormality can be successfully corrected by releasing the fundiform ligament and mobilising the scrotal skin to cover the length of the penile shaft. The study shows that the paucity and traction of the penile skin and an abnormal fundiform ligament are important anatomical defects in CCBP. Dorsal curve and severe shortage of penile skin in erectile conditions are the main indications for surgical correction.
To present our experience of anatomical findings for congenital completely buried penis (CCBP), which has no unanimous consensus regarding the 'gold standard' for surgical correction and patient eligibility, by providing our surgical technique and illustrations.
Between February 2006 and February 2011, 22 children with a median (range) age of 4.2 (2.5-5.8) years, with CCBP underwent surgical correction by one surgeon. Toilet training and photographs of morning erections by parents were advised before surgery. The abnormal anatomical structure of buried penis during the operation was observed. The technique consisted of the release of the fundiform ligament, fixation of the subcutaneous penile skin at the base of the degloved penis, penoscrotal Z-plasty and mobilisation of the penile and scrotal skin to cover the penile shaft.
In reflex erectile conditions, CCBP presents varying degrees of dorsal curve and shortage of penile skin. Dysgenetic fundiform ligaments were found to be attached to the distal or middle shaft of the penis in all patients. All wounds healed well and the cosmetic outcome was good at 6-month follow-up after the repair.
The appearance of the dorsal curve in CCBP mainly results from the traction of penile dorsal skin and the abnormal attachment of the fundiform ligament to the shaft. This abnormality can be successfully corrected by releasing the abnormal fundiform ligament and mobilising scrotal skin to cover the length of the penile shaft.
介绍先天性完全埋藏性阴茎（CCBP）的解剖学发现，对于手术矫正的“金标准”和患者手术适应证尚无共识，同时提供我们的手术技术和图示。
2006 年 2 月至 2011 年 2 月，由一位外科医生为 22 例年龄中位数（范围）为 4.2（2.5-5.8）岁的 CCBP 患儿实施手术矫正。手术前，建议患儿父母进行如厕训练并拍摄晨勃时的照片。观察手术中埋藏性阴茎的异常解剖结构。该技术包括释放悬韧带、固定脱套阴茎根部的皮下阴茎皮肤、阴茎阴囊 Z 成形术和阴茎及阴囊皮肤的移动以覆盖阴茎干。
在反射性勃起状态下，CCBP 表现出不同程度的背侧弯曲和阴茎皮肤短缺。所有患者均发现发育不良的悬韧带附着于阴茎的远端或中段。所有伤口愈合良好，修复后 6 个月随访时外观良好。
CCBP 中的背侧弯曲主要是由于阴茎背侧皮肤的牵拉和悬韧带异常附着于阴茎干所致。通过释放异常的悬韧带和移动阴囊皮肤来覆盖阴茎干的长度，可以成功纠正这种异常。
