Cromie W J, Ritchey M L, Smith R C, Zagaja G P
Department of Surgery, University of Chicago, Illinois, USA.
J Urol. 1998 Oct;160(4):1482-4.
We report a straightforward surgical technique for the correction and anatomical alignment of the skin in patients with various degrees of buried penis.
A combined series of 74 patients 7 months to 10 years old who were treated for buried penis at 2 institutions during a 7-year period. Patients presented with various symptoms, including balanitis, urinary tract infection, painful voiding, ballooning of the foreskin and urinary retention. In 29 patients (38%) trapped penis was due to previous circumcision. In our estimation the major anatomical defect in buried penis is an insufficient attachment of the dartos fascia and penile skin to Buck's fascia. Our technique involves making a circumferential incision of the inner preputial skin layer proximal to the corona, unfurling it from the shaft skin and leaving a coronal collar of approximately 1 cm. The annular band that usually constricts the corpora on retraction of the penile skin is incised, and the remaining proximal penile skin and dartos fascia are dissected off Buck's fascia proximally to the base of the penis. The penile dermis is sutured to the lateral aspect of the tunica albuginea at the penopubic junction and mid shaft of the penis. This technique restores normal anatomical relationships with excellent cosmetic results and negligible complications.
At a median 5-year followup cosmesis was excellent in all cases. Two patients with micropenis who required revision responded to endocrine therapy.
Excellent cosmetic results were obtained in all cases using this surgical technique.
我们报告一种用于矫正不同程度隐匿阴茎患者皮肤并使其解剖复位的简单手术技术。
在7年期间，两家机构共收治了74例年龄在7个月至10岁之间的隐匿阴茎患者。患者表现出各种症状，包括龟头炎、尿路感染、排尿疼痛、包皮肿胀和尿潴留。29例（38%）隐匿阴茎患者是由于既往包皮环切术所致。我们认为隐匿阴茎的主要解剖缺陷是肉膜筋膜和阴茎皮肤与白膜的附着不足。我们的技术包括在冠状沟近端的包皮内层皮肤做环形切口，将其从阴茎体皮肤展开，保留约1厘米宽的冠状沟皮圈。切开通常在阴茎皮肤回缩时压迫阴茎海绵体的环形带，将阴茎近端剩余的皮肤和肉膜筋膜从阴茎根部向近端剥离至阴茎白膜。将阴茎真皮缝合至耻骨联合处和阴茎体中部白膜的外侧。该技术恢复了正常的解剖关系，美容效果极佳，并发症极少。
中位随访5年时，所有病例的美容效果均极佳。2例小阴茎患者需要再次手术，经内分泌治疗后有反应。
使用该手术技术在所有病例中均获得了极佳的美容效果。
