A New Surgical Technique for the Treatment of Congenital Concealed Penis Based on Anatomical Finding

No AccessJournal of UrologyNew Technology and Techniques1 Dec 2020A New Surgical Technique for the Treatment of Congenital Concealed Penis Based on Anatomical FindingThis article is commented on by the following:Editorial CommentEditorial Comment Hongyi Zhang, Ganggang Zhao, Gaifeng Feng, Hua Han, Huafeng Li, Kebing Xiao, Yiting Song, and Jie Cui Hongyi ZhangHongyi Zhang Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Ganggang ZhaoGanggang Zhao Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Gaifeng FengGaifeng Feng Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Hua HanHua Han Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Huafeng LiHuafeng Li Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Kebing XiaoKebing Xiao Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , Yiting SongYiting Song Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author , and Jie CuiJie Cui *Correspondence: School of General Medicine, Xi’an Medical University, No. 48 Fenghao West Road, Xi’an710077, Shaanxi Province , People’s Republic of China telephone: +86 29 84278411; FAX: +86 29 84278411; E-mail Address: [email protected] School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001300AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Surgery is the first line treatment for congenital concealed penis but penile retraction is inevitable in some cases. We investigate the anatomical and histological characteristics of penile fasciae and describe a new technique for the correction of concealed penis. Materials and Methods: The anatomical structures of penile fasciae were observed in 10 adult cadaveric penises. Penile tissue samples were stained with hematoxylin-eosin, Masson's trichrome and Weigert's resorcin-fuchsin, respectively. From January 2017 to May 2019, 78 patients with congenital concealed penis were treated with the new surgical technique. Median patient age was 14 years (range 8 to 18). Results: Dartos fascia had sublayers. The superficial layer was a well vascularized tissue composed of nonpolar collagen fibers intermixed with nerves and vessels. The deep layer was composed of a transverse arrangement of collagen fibers and elastic fibers, and there were fewer venules and nerve fibers. Based on this finding we performed anatomical resection of the deep layer of dartos fascia to correct concealed penis. During the operation dartos fascia was separated into 2 layers and a complete circular resection of the deep layer was made at the base of the penis. Mean followup was 14 months. All patients and their parents were satisfied with the outcomes. None of the patients underwent postoperative penile retraction. Conclusions: The anatomical resection of the deep layer of dartos fascia for correcting concealed penis is technically easy, safe and effective. It provides a good cosmetic appearance and functional outcomes. References 1. : New technique for the treatment of buried penis in children. Urology 2016; 88: 166. Google Scholar 2. : The inconspicuous penis in children. Nat Rev Urol 2015; 12: 205. Google Scholar 3. : Therapeutic effects of modified Devine surgery for concealed penis in children. Asian J Surg 2019; 42: 356. Google Scholar 4. : Congenital completely buried penis in boys: anatomical basis and surgical technique. BJU Int 2013; 112: 271. 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No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of UrologySep 30, 2020, 12:00:00 AMEditorial CommentJournal of UrologySep 30, 2020, 12:00:00 AMEditorial Comment Volume 204Issue 6December 2020Page: 1341-1348Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordscongenital abnormalitiesoperativepenisfasciasurgical proceduresAcknowledgmentsThe Department of Pathology, The First Affiliated Hospital of Xi’an Medical University provided assistance with histological analysis.MetricsAuthor Information Hongyi Zhang Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Ganggang Zhao Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Gaifeng Feng Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Hua Han Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Huafeng Li Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Kebing Xiao Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Yiting Song Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China More articles by this author Jie Cui School of General Medicine of Xi’an Medical University, Xi’an, Shaanxi Province, People’s Republic of China *Correspondence: School of General Medicine, Xi’an Medical University, No. 48 Fenghao West Road, Xi’an710077, Shaanxi Province , People’s Republic of China telephone: +86 29 84278411; FAX: +86 29 84278411; E-mail Address: [email protected] More articles by this author Expand All Supported by Science and Technology Department of Shaanxi Province (Grant No. 2018SF-234). 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