Eroglu Egemen, Gundogdu Gokhan
Department of Pediatric Surgery, Koc University School of Medicine, Istanbul, Turkey.
Can Urol Assoc J. 2015 Nov-Dec;9(11-12):E805-7. doi: 10.5489/cuaj.2833. Epub 2015 Nov 4.
We reported on the incidence of isolated penile torsion among our healthy children and our approach to this anomaly.
Between 2011 and 2014, newborn babies with penile torsion were classified according to the angle of torsion. Surgical correction (penile degloving and reattachment for moderate cases and dorsal dartos flap technique in case of resistance) after 6 months was advised to the babies with rotations more than 45°.
Among 1000 newborn babies, 200 isolated penile torsions were found, and among these, 43 had torsions more than 45°, and 4 of these had angles greater than 90°. The mean angle of the rotations was found 30.45° (median: 20°). In total, 8 children with 60° torsions were previously circumcised. Surgery was performed on 19 patients, with a mean patient age of 12 ± 2 months. Of these 19, 13 babies were corrected with degloving and reattachment. This technique was not enough on the remaining 6 patients; therefore, derotational dorsal dartos flap was added to correct the torsion. After a mean of 15.6 ± 9.8 months, residual penile rotation, less than 15°, was found only in 2 children.
The incidence of isolated penile torsion is 20% in newborns. However, rotation more than 45° angles are seen in 4.3% of male babies. Correction is not necessary in mild degrees, and penile degloving with reattachment is enough in most cases. If the initial correction is insufficient, dorsal dartos flap rotation is easy and effective. Prior circumcision neither disturbs the operative procedure nor affects the outcomes.
我们报告了健康儿童中孤立性阴茎扭转的发生率以及我们对这种异常情况的处理方法。
在2011年至2014年期间,对患有阴茎扭转的新生儿根据扭转角度进行分类。对于扭转超过45°的婴儿,建议在6个月后进行手术矫正(中度病例采用阴茎脱套和重新附着,若有阻力则采用背侧肉膜瓣技术)。
在1000名新生儿中,发现200例孤立性阴茎扭转,其中43例扭转超过45°,4例角度大于90°。发现扭转的平均角度为30.45°(中位数:20°)。共有8例扭转60°的儿童之前已行包皮环切术。对19例患者进行了手术,患者平均年龄为12±2个月。在这19例中,13例婴儿通过脱套和重新附着进行了矫正。该技术对其余6例患者不够用;因此,增加了背侧肉膜瓣旋转以矫正扭转。平均15.6±9.8个月后,仅2例儿童发现残余阴茎扭转小于15°。
新生儿中孤立性阴茎扭转的发生率为20%。然而,4.3%的男婴扭转角度超过45°。轻度扭转无需矫正,大多数情况下阴茎脱套和重新附着就足够了。如果初始矫正不足,背侧肉膜瓣旋转简便有效。既往包皮环切术既不干扰手术操作也不影响手术结果。