Department of Pediatric Surgery, La Paz Children´s University Hospital, Madrid, Spain; Department of Pediatric Urology, La Paz Children´s University Hospital, Madrid, Spain.
Department of Pediatric Surgery, La Paz Children´s University Hospital, Madrid, Spain; Department of Pediatric Urology, La Paz Children´s University Hospital, Madrid, Spain.
J Pediatr Urol. 2022 Apr;18(2):185.e1-185.e6. doi: 10.1016/j.jpurol.2021.12.016. Epub 2022 Jan 7.
Several surgical techniques for buried penis (BP) treatment have been described, although there is not a reference pattern for it. In our institution, we have traditionally performed penis fixation to Buck's fascia at 3 points. In 2014 we introduced a dorsal dartos flap technique, fixed at both sides of the penis base.
To compare both techniques and their long-term outcomes.
A retrospective cohort study was conducted on consecutive patients with BP who underwent surgery between 2010 and 2018. They were divided according to surgical technique performed: group A (fascia fixation) and B (dorsal dartos flap). Demographic variables, surgical time and postoperative complications were analyzed. Long-term cosmetic outcomes were evaluated through a telephone survey to patients parents.
Thirty-five patients were included (16 group A; 19 group B). Median age at intervention was 9.7 years in group A, with no statistical differences with group B (7.3 years; p = 0.071). No statistically significant differences were observed in mean surgical time or postoperative complications between both groups. Cosmetic outcomes (Table 2) were significantly better in group B, which presented higher percentages of satisfaction with the outcomes (95% vs. 64%; p = 0.02) and age at intervention (89% vs. 59%; p = 0.032), higher perception of the procedure as "minimally invasive" (100% vs. 71%; p = 0.013) and higher recommendation rate of the intervention (95% vs. 57%; p = 0.029).
Dorsal dartos flap is a reproducible, minimally invasive technique with minimal adverse effects and satisfactory long-term results. It has fewer postoperative complications and more satisfactory cosmetic results compared to fascia fixation.
已经描述了几种治疗埋藏性阴茎（BP）的手术技术，但没有参考模式。在我们的机构中，我们传统上在 3 点将阴茎固定到Buck筋膜。2014 年，我们引入了一种阴茎基部两侧固定的背侧阴茎深筋膜皮瓣技术。
比较两种技术及其长期结果。
对 2010 年至 2018 年间接受手术的连续 BP 患者进行回顾性队列研究。根据手术技术分为两组：A 组（筋膜固定）和 B 组（背侧阴茎深筋膜皮瓣）。分析了人口统计学变量、手术时间和术后并发症。通过电话调查患者家长，评估长期美容效果。
共纳入 35 例患者（A 组 16 例，B 组 19 例）。A 组的中位年龄为 9.7 岁，与 B 组无统计学差异（7.3 岁；p=0.071）。两组间平均手术时间或术后并发症无统计学差异。B 组的美容效果（表 2）明显更好，满意度更高（95% vs. 64%；p=0.02），干预时年龄更高（89% vs. 59%；p=0.032），认为手术程序“微创”的比例更高（100% vs. 71%；p=0.013），推荐干预的比例更高（95% vs. 57%；p=0.029）。
背侧阴茎深筋膜皮瓣是一种可重复、微创、不良反应少且长期效果满意的技术。与筋膜固定相比，它的术后并发症更少，美容效果更满意。
