Yuri Prahara, Wiratma Made Kresna Yudhistira
Division of Urology, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta 55281, Indonesia.
Division of Urology, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta 55281, Indonesia.
Int J Surg Case Rep. 2024 Jan;114:109214. doi: 10.1016/j.ijscr.2023.109214. Epub 2024 Jan 3.
Circumcised concealed penis (CP) patients will have insufficient penile shaft skin, causing difficulty to perform reconstructive surgery. There hasn't been a single, widely acknowledged surgical procedure for all varieties of CP repairs until lately. We report a novel surgical technique with combination of penile and scrotal skin flap for circumcised concealed penis.
A 9-year-old boy concealed penis patient with history of circumcision was corrected with combination of penile and scrotal flap. Three important steps in this technique include preparation of penile skin flap, preparation of scrotal skin flap and skin coverage. Indicators were measured with detail such as the pre- and post-operative penile length, as well as the intraoperative time and bleeding during the operation. After surgery patient achieved a clinically significant improvement in the appearance post operatively including penile length and morphology. During 3 months of follow up there are no complication such as necrosis, contracture, voiding and erectile function are also maintained during follow up.
Acquired concealed penis cases usually occur as a complication of neonatal circumcision which causes entrapment of penis by postoperative cicatricial scar over the glans. A new combination technique by using scrotal and penile flap allows mobile and richly vascularized skin of the scrotum to cover defects of penis shaft.
This technique is well tolerated for the case. The lack of skin coverage after circumcision procedure can be overcome while preserving all of the rest penile skin.
包皮环切隐匿阴茎（CP）患者阴茎体皮肤不足，给重建手术带来困难。直到最近，对于各种类型的CP修复，还没有一种被广泛认可的单一手术方法。我们报告一种用于包皮环切隐匿阴茎的阴茎和阴囊皮瓣联合的新型手术技术。
一名9岁有包皮环切史的隐匿阴茎男孩采用阴茎和阴囊皮瓣联合进行矫正。该技术的三个重要步骤包括阴茎皮瓣制备、阴囊皮瓣制备和皮肤覆盖。详细测量了术前和术后阴茎长度等指标，以及术中时间和手术中的出血量。术后患者在外观上，包括阴茎长度和形态方面，取得了临床上显著的改善。在3个月的随访期间，没有出现坏死、挛缩等并发症，随访期间排尿和勃起功能也得以维持。
后天性隐匿阴茎病例通常作为新生儿包皮环切术的并发症出现，术后龟头的瘢痕挛缩导致阴茎被束缚。一种使用阴囊和阴茎皮瓣的新联合技术，可使阴囊活动且血管丰富的皮肤覆盖阴茎体的缺损。
该技术对此病例耐受性良好。包皮环切术后皮肤覆盖不足的问题可以得到解决，同时保留其余所有阴茎皮肤。
