Yalçın Kenan, Fırat Fatih
Department of Urology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Türkiye.
Urol J. 2024 Aug 18. doi: 10.22037/uj.v21i.8200.
Penile torsion is a counterclockwise rotational anomaly of the penile shaft or glans. We aimed to evaluate the results of dorsal dartos flap rotation technique in children with isolated penile torsion.
5470 boys who applied to our clinic between 2012 and 2022 for circumcision were evaluated for congenital isolated penile torsion. They were classified according to the degree and direction of torsion and clinical findings were analyzed. According to the degree of torsion, penile degloving or dorsal dartos flap rotation technique with circumcision was performed. Patients whose torsion corrected after penile degloving were excluded from the study. The results of dorsal dartos flap rotation technique were evaluated. Results: Congenital isolated penile torsion ≥60° was identified in 1.04 % (n=57) of the children. Eight patients whose torsion corrected after penile degloving were excluded from the study. 49 patients who underwent dorsal dartos flap rotation had a mean age of 4.94 years (1-9) and a mean operation time of 29.9 min (20-40). The mean degree of torsion was 77.6° (60-110). The mean operation times in the < 90° and ≥ 90° dorsal dartos flap groups were statistically significant (p<0.05). Residual torsion was statistically significant in the < 90° and ≥ 90° dorsal dartos flap groups (p<0.05). At the postoperative 1st and 6th month follow-ups, torsion less than 10 degrees was observed in 3 patients who underwent dorsal dartos flap rotation technique. No residual torsion was observed in other patients.
Isolated penile torsion cases should not be overlooked during circumcision. It seems possible to obtain successful results with dorsal dartos flap rotation in moderate and severe torsions.
阴茎扭转是阴茎体或龟头逆时针旋转异常。我们旨在评估背侧肉膜瓣旋转技术治疗孤立性阴茎扭转患儿的效果。
对2012年至2022年间到我院门诊行包皮环切术的5470名男孩进行先天性孤立性阴茎扭转评估。根据扭转程度和方向进行分类，并分析临床特征。根据扭转程度，行阴茎脱套或背侧肉膜瓣旋转联合包皮环切术。阴茎脱套后扭转得到纠正的患者被排除在研究之外。评估背侧肉膜瓣旋转技术的效果。结果：1.04%（n = 57）的患儿存在先天性孤立性阴茎扭转≥60°。8例阴茎脱套后扭转得到纠正的患者被排除在研究之外。49例行背侧肉膜瓣旋转术的患者平均年龄为4.94岁（1 - 9岁），平均手术时间为29.9分钟（20 - 40分钟）。平均扭转度数为77.6°（60 - 110°）。<90°和≥90°背侧肉膜瓣组的平均手术时间有统计学意义（p<0.05）。<90°和≥90°背侧肉膜瓣组的残余扭转有统计学意义（p<0.05）。在术后第1个月和第6个月随访时，3例行背侧肉膜瓣旋转术的患者扭转度数小于10度。其他患者未观察到残余扭转。
包皮环切术时不应忽视孤立性阴茎扭转病例。对于中度和重度扭转，背侧肉膜瓣旋转术似乎有可能取得成功的结果。
