Kurtuluş Şenay, Süzen Alev, Sılan Fatma, Öztopuz Rahime Özlem
Department of Pediatric Surgery, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
Department of Pediatric Surgery, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.
J Pediatr Surg. 2024 Aug;59(8):1526-1530. doi: 10.1016/j.jpedsurg.2024.03.036. Epub 2024 Mar 20.
A buried penis (BP) is rare in which the penile body is retracted into the prepubic adipose tissue. This research focuses on differences in smooth muscle myosin heavy chain (SMMHC) isoform expressions in the dartos fascia.
A total of 82 children, 41 of whom had BPs, who applied for circumcision between May and November 2021, were included in the study. The cases were divided into four groups aged ≥6 years (NP6, n = 18) and aged ≤3 years (NP3, n = 17) with normal penile appearance, aged ≥6 years (BP6, n = 23) and aged ≤3 years (BP,n = 24) with a BP. SMMHC isoforms mRNA gene expression analyses were performed by quantitative PCR technique in dartos fascia obtained from foreskin removed by circumcision.
Compared to the NP3 group, the SM1 mRNA expressed in the BP6 group was statistically significantly higher (p < 0.005). SM2 mRNA levels expressed in dartos fascia were considerably higher in NP6 and NP3 groups compared to BP6 and BP3 groups (p < 0.001). The SM2/SM1 ratio was 0.85 in the BP6 group and 1.46 in the NP6 group, which was statistically significant (p = 0.006) and increased from 0.87 in the BP3 group to 2.21 in the NP3 group (p < 0.001).
In a buried penis, there is a difference in the expression of SMMHC isoforms. SM1 is highly expressed, while SM2 decreases, increasing the SM2/SM1 ratio. This causes increased contractility in the smooth muscle, leading to retraction of the penile body. The dartos fascia surrounding it resembles aberrant muscle tissue in boys with a BP.
Level III.
Case-control study.
隐匿阴茎（BP）较为罕见，其阴茎体回缩至耻骨前脂肪组织中。本研究聚焦于肉膜肌中平滑肌肌球蛋白重链（SMMHC）亚型表达的差异。
本研究纳入了2021年5月至11月期间申请包皮环切术的82名儿童，其中41名患有隐匿阴茎。将病例分为四组：阴茎外观正常且年龄≥6岁（NP6，n = 18）、阴茎外观正常且年龄≤3岁（NP3，n = 17）、患有隐匿阴茎且年龄≥6岁（BP6，n = 23）、患有隐匿阴茎且年龄≤3岁（BP3，n = 24）。采用定量PCR技术对包皮环切术切除的包皮中获取的肉膜肌进行SMMHC亚型mRNA基因表达分析。
与NP3组相比，BP6组中表达的SM1 mRNA在统计学上显著更高（p < 0.005）。与BP6组和BP3组相比，NP6组和NP3组肉膜肌中表达的SM2 mRNA水平显著更高（p < 0.001）。BP6组的SM2/SM1比值为0.85，NP6组为1.46，具有统计学意义（p = 0.006），且从BP3组的0.87增加到NP3组的2.21（p < 0.001）。
在隐匿阴茎中，SMMHC亚型的表达存在差异。SM1高表达，而SM2降低，导致SM2/SM1比值增加。这会使平滑肌收缩性增强，导致阴茎体回缩。其周围的肉膜肌类似于患有隐匿阴茎男孩的异常肌肉组织。
三级。
病例对照研究。
