Department of Surgery, Tanta University Hospitals, Elgeish Road, Tanta, Egypt.
Department of Surgery, Tanta University Hospitals, Elgeish Road, Tanta, Egypt.
J Pediatr Urol. 2014 Dec;10(6):1187-92. doi: 10.1016/j.jpurol.2014.05.009. Epub 2014 Jun 20.
To evaluate the correction of different degrees of penile torsion following a ladder step so that simpler steps are used whenever possible. This can avoid the morbidity and complications of complex procedures.
Cases of congenital and acquired penile torsion were repaired on a ladder step basis irrespective of the degree of torsion, starting with degloving and skin realignment, then a dorsal dartos flap and finally corporopexy. The torsion is checked with artificial erection after each step, and if corrected completely then the next step(s) is omitted.
Twenty-five cases of penile torsion (30-180°) were repaired over a 4-year period. Three cases were corrected by degloving only, 12 by degloving and skin realignment, five by a dartos flap and four required a corporopexy. Postoperative complications included five cases of penile edema, one case of hematoma and one case of dorsal skin gangrene. Residual torsion of <15° occurred in three cases. No cases required redo surgery.
A ladder step approach is a good option for penile torsion repair, starting with simpler techniques until complete correction is achieved. There is no need to plan a complex procedure in advance.
评估阴茎扭转不同程度的梯级矫正，以便尽可能采用更简单的步骤。这可以避免复杂手术的发病率和并发症。
无论扭转程度如何，我们均采用梯级修复法对先天性和后天性阴茎扭转进行修复，从脱套和皮肤矫正开始，然后进行背侧筋膜皮瓣，最后进行阴茎海绵体固定术。每一步完成后，用人工勃起检查扭转情况，如果完全矫正，则省略下一步（或下一步）。
在 4 年期间，我们修复了 25 例阴茎扭转（30-180°）病例。仅通过脱套即可矫正 3 例，脱套和皮肤矫正 12 例，筋膜皮瓣 5 例，阴茎海绵体固定术 4 例。术后并发症包括 5 例阴茎水肿、1 例血肿和 1 例背侧皮肤坏死。3 例残余扭转<15°。没有病例需要再次手术。
梯级修复法是阴茎扭转修复的一种较好选择，从更简单的技术开始，直到完全矫正。无需事先计划复杂的手术。
