Zou Jinhan,Ruan Shuai,Zhou Yixin,et al.Comparison of clinical efficacy between modified penis lengthening and plastic surgery and modified Devine surgery for concealed penis[J].Journal of Clinical Pediatric Surgery,,21():1081-1085.[doi:10.3760/cma.j.cn101785-202207010-015]
Comparison of clinical efficacy between modified penis lengthening and plastic surgery and modified Devine surgery for concealed penis
- Keywords:
- Penis; Anatomy; Histology; Penile Prosthesis; Penile Erection; Surgery; Plastic
- Abstract:
- Objective To compare the clinical efficacy of modified penis lengthening and plastic surgery and modified Devine surgery for concealed penis.Methods From January 2018 to April 2022, 106 children with concealed penis undergoing surgery were selected as research subjects.According to surgical approaches, they were divided into two groups of modified Devine (n=51) and modified penile lengthening plus plastic surgery (n=55).The former group underwent modified Devine penile release while the latter group had modified penile extension and phalloplasty with integral detachment and fixation of superficial and deep penile fascia.Operative duration, intraoperative volume of blood loss, perioperative/follow-up penile length and postoperative overall score were compared between two groups.Results All operations were successfully completed.In modified Devine surgery and modified penile lengthening & plastic surgery groups, operative duration was (44.29±3.06) vs.(43.31±2.89) min and intraoperative volume of blood loss (6.82±1.75) vs.(6.71±1.40) mL.And no statistically significant differences existed (P>0.05);preoperative penile length was (1.06±0.70)vs.(1.25±0.70) cm, postoperative penile length (3.80±0.72) cm vs.(4.71±0.75) cm, penile increment (2.74±0.56) to (2.86±0.51) cm, penile retraction length (0.88±0.49) to (0.80±0.41) cm and final penile length (1.86±0.43) to (2.05±0.46).Among them, postoperative penile length, follow-up penile length and final increment in modified penis elongation & plastic surgery group were better than those in modified Devine group (P<0.05).The differences were not statistically significant (P>0.05).The complication scores of two groups were (3.59±0.61) versus (3.80±0.45) points, satisfaction score of penile shape (2.10±0.43) versus (2.24±0.43) points, scores of other aspects (2.41±0.50) vs.(2.56±0.59) and total scores (8.06±1.09) vs.(8.60±1.08).Complication score and total score of modified penis elongation & plastic surgery group were better than those of modified Devine group.No significant inter-group difference existed in satisfaction score of penile shape or other aspects (P>0.05).Conclusion Modified penis lengthening & plastic surgery is reliable for pediatric concealed penis.Operative procedures are simple and patients may obtain a more ideal postoperative penile length.
References:
[1] 中华医学会男科学分会.儿童隐匿性阴茎诊治的中国专家共识[J].中华男科学杂志, 2021, 27(10):941-947.DOI:10.13263/j.cnki.nja.2021.10.012. Branch of Andrology, Chinese Medical Association.Chinese Expert Consensus on Diagnosing and Treating Concealed Penis in Children[J].Natl J Androl, 2021, 27(10):941-947.DOI:10.13263/j.cnki.nja.2021.10.012.
[2] 侯昱竹, 郭玺, 段燚星.隐匿性阴茎的病因及治疗研究进展[J].山东医药, 2021, 61(18):98-101.DOI:10.3969/j.issn.1002-266X.2021.18.025. Hou YZ, Guo X, Duan YX.Research advances on etiologies and treatments of concealed penis[J].Shandong Med J, 2021, 61(18):98-101.DOI:10.3969/j.issn.1002-266X.2021.18.025.
[3] 高志翔, 刘晓龙.隐匿阴茎的诊治进展[J].中国男科学杂志, 2021, 35(1):73-75, 80.DOI:10.3969/j.issn.1008-0848.2021.01.016. Gao ZX, Liu XL.Recent advances of diagnosing and treating concealed penis[J].Chin J Androl, 2021, 35(1):73-75, 80.DOI:10.3969/j.issn.1008-0848.2021.01.016.
[4] 白恒舟, 乔保平.隐匿性阴茎诊断和治疗进展[J].河南医学研究, 2017, 26(19):3510-3512.DOI:10.3969/j.issn.1004-437X.2017.19.026. Bai HZ, Qiao BP.Recent advances in diagnosing and treating occult penis[J].Henan Med Res, 2017, 26(19):3510-3512.DOI:10.3969/j.issn.1004-437X.2017.19.026.
[5] 李心, 李养群.隐匿性阴茎的病因及整形外科治疗[J].中国医疗美容, 2022, 12(4):66-70.DOI:10.19593/j.issn.2095-0721.2022.04.016. Li X, Li YQ.Etiology and plastic surgery treatment of concealed penis[J].China Medical Cosmetology, 2022, 12(4):66-70.DOI:10.19593/j.issn.2095-0721.2022.04.016.
[6] Chen HK, Chu YS, Hu YF.The modified Devine’s procedure for the management of concealed penis in children:an experience of 131 cases[J].Eur Rev Med Pharmacol Sci, 2022, 26(13):4592-4596.DOI:10.26355/eurrev_202207_29180.
[7] Su QX, Gao SL, Lu C, et al.Clinical effect of Brisson operation modified by Y-shaped incision for treatment of concealed penis in adolescents[J].J Int Med Res, 2021, 49(4):3000605211005951.DOI:10.1177/03000605211005951.
[8] Ge WL, Zhu X, Xu YZ, et al.Therapeutic effects of modified Devine surgery for concealed penis in children[J].Asian J Surg, 2019, 42(1):356-361.DOI:10.1016/j.asjsur.2018.06.007.
[9] Chen HC, Wu YL, Xu YB.Effectiveness of modified Brisson surgery in treatment of severe concealed penis[J].Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(12):1581-1585.DOI:10.7507/1002-1892.201806118.
[10] 黄鲁刚, 曾莉.儿童隐匿阴茎的诊治现状及最新进展[J].临床小儿外科杂志, 2018, 7(12):886-890.DOI:10.3969/j.issn.1671-6353.2018.12.002. Huang LG, Zeng L.Current diagnosis & treatment and recent advances of concealed penis in children[J].J Clin Ped Sur, 2018, 17(12):886-890.DOI:10.3969/j.issn.1671-6353.2018.12.002.
[11] 杨屹, 许卓凡.隐匿阴茎手术治疗争议及随访研究进展[J].临床小儿外科杂志, 2018, 17(12):881-885.DOI:10.3969/j.issn.1671-6353.2018.12.001. Yang Y, Xu ZF.Surgical controversies and follow-up study of concealed penis[J].J Clin Ped Sur, 2018, 17(12):881-885.DOI:10.3969/j.issn.1671-6353.2018.12.001.
[12] 唐达星, 吴德华, 陶畅, 等.隐匿性阴茎矫治术后常见并发症及处理[J].中华男科学杂志, 2012, 18(5):450-454.DOI:10.13263/j.cnki.nja.2012.05.028. Tang DX, Wu DH, Tao C, et al.Common complications and treatment after concealed penile correction[J].Natl J Androl, 2012, 18(5):450-454.DOI:10.13263/j.cnki.nja.2012.05.028.
[13] 殷玮琪, 王国耀, 吴科荣.隐匿性阴茎新术式减轻术后包皮水肿的优势分析[J].中华男科学杂志, 2019, 25(10):901-904.DOI:10.13263/j.cnki.nja.2019.10.006. Yin WQ, Wang GY, Wu KR.A new procedure of penoplasty for concealed penis reduces postoperative preputial edema[J].Natl J Androl, 2019, 25(10):901-904.DOI:10.13263/j.cnki.nja.2019.10.006.
[14] Huang WF, Tang DX, Gu WZ.The characteristics and distribution of nerve plexuses in the dartos fascia from concealed penis children[J].Front Pediatr, 2021, 9:705155.
[15] 侯昱竹.肥胖指数、耻骨联合前脂肪厚度与隐匿性阴茎手术疗效的相关性分析[D].长沙:湖南师范大学, 2021. Hou YZ.Correlation analysis of body mass index, thickness of pre-pubic symphysis fat and curative effect of concealed penile surgery[D].Changsha:Hunan Normal University, 2021.
Memo
收稿日期:2022-07-06。
基金项目:湖南省卫生健康委科研课题（20200256）
通讯作者:郭玺,Email:393913230@qq.com