Elrouby Ahmed, Saad Israa, Kotb Mostafa
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Front Pediatr. 2023 Jan 20;10:1001825. doi: 10.3389/fped.2022.1001825. eCollection 2022.
Concealed penis, which is the congenital type of buried penis, is a condition in which a normal-sized penis is totally or partially hidden by pubic, scrotal, or thigh skin. Several procedures had been described for its correction including phallopexy, that is, fixation of penile Buck's fascia to the sub-dermis.
Our work aims to study the difference in outcome between performing phallopexy at one level and at two levels.
Our study included 180 uncircumcised patients who had a concealed penis while having an average length of an outstretched penis. These patients were divided into two groups: the first one was treated with one level of phallopexy at the 3 and 9 o'clock points, while the second group was treated with the same procedure in addition to another level of stitches at the mid-penile level. The follow-up was carried out for one post-operative year regarding penile skin edema, infection, congestion, necrosis, and/or re-retraction.
The overall success rate was 96.1% for a normally-looking penis without post-operative re-retraction. Re-retraction developed in two patients (2.2%) of those who had one-level phallopexy and in five patients (5.6%) of those who had two-level phallopexy without statistical significance ( = .444). Penile skin edema developed in 76 patients (42.2%) being significantly lower in patients with lower body weight ( = .030*).
Phallopexy could be performed safely in the case of the concealed penis with satisfactory results. Two levels of phallopexy did not add any advantage to the post-operative results besides the fact that this may be demanding, time-consuming, and may require higher resources, so we recommend the easier one-level phallopexy in the treatment of such conditions with satisfactory results.
隐匿阴茎是埋藏阴茎的先天性类型，指正常大小的阴茎全部或部分被耻骨、阴囊或大腿皮肤遮盖。已有多种矫正方法被描述，包括阴茎固定术，即将阴茎白膜固定于皮下。
本研究旨在探讨单水平阴茎固定术与双水平阴茎固定术在治疗效果上的差异。
本研究纳入180例未行包皮环切术且阴茎平均伸展长度正常的隐匿阴茎患者。这些患者被分为两组：第一组在3点和9点位置行单水平阴茎固定术，第二组除在上述位置行相同手术外，还在阴茎中部增加一层缝合。术后随访一年，观察阴茎皮肤水肿、感染、充血、坏死和/或回缩情况。
术后阴茎外观正常且无回缩的总体成功率为96.1%。单水平阴茎固定术组有2例患者（2.2%）出现回缩，双水平阴茎固定术组有5例患者（5.6%）出现回缩，差异无统计学意义（P = 0.444）。76例患者（42.2%）出现阴茎皮肤水肿，体重较低的患者水肿发生率显著更低（P = 0.030*）。
隐匿阴茎患者行阴茎固定术安全，效果满意。双水平阴茎固定术除可能要求更高、耗时更长且资源需求更多外，并未给术后结果带来任何优势，因此我们建议在治疗此类疾病时采用更简便的单水平阴茎固定术，效果满意。
