ABSTRACT
Concealed penis is usually found in children, which affects the patients both physiologically and psychologically. Some of the patients are wrongly treated by circumcision, which may bring about serious consequences to the sexual life of the patients in their adulthood. In the recent years, this disease has been receiving more and more attention from both doctors and parents. However, controversies remain as to its classification, pathogenesis, pathology, and treatment. This paper focuses on the understanding and advances in the studies of concealed penis.
Subject(s)
Child , Humans , Male , Circumcision, Male , Psychology , Penis , Congenital Abnormalities , General Surgery , Sexual BehaviorABSTRACT
<p><b>OBJECTIVE</b>To investigate the application of tunica dartos flap coverage to the prevention of urinary fistula in tubularized incised plate (TIP) urethroplasty.</p><p><b>METHODS</b>This study included 140 cases of hypospadias following TIP urethroplasty, aged 1.9-22 (mean 5.6) years. Of the total number, 85 cases of the distal type were treated by coverage of the neourethra with the longitudinal ventrolateral pedicled-dartos penile skin flap, while the other 55 cases of the proximal type with the pedicled-dartos flap of arteriae scrotales anteriories.</p><p><b>RESULTS</b>Urethrocutaneous fistula occurred in 12 of the patients, including 7 cases of distal and 6 cases of proximal hypospadias.</p><p><b>CONCLUSION</b>For distal hypospadias, the longitudinal ventrolateral pedicled-dartos penile skin flap can be used, while for proximal urethroplasty, the pedicled-dartos flap of arteriae scrotales anteriories can be applied in coverage of the neourethra, which can effectively reduce the incidence of fistula.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Male , Young Adult , Hypospadias , General Surgery , Plastic Surgery Procedures , Methods , Scrotum , Subcutaneous Tissue , Transplantation , Surgical Flaps , Urethra , General Surgery , Urinary Fistula , General Surgery , Urologic Surgical Procedures, Male , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of epididymal obstructive azoospermia (OA) by microsurgery.</p><p><b>METHODS</b>We performed surgical scrotal exploration for 57 cases of OA whose obstruction was suspected to be in the epididymis. Those confirmed to be epididymal OA cases and with motile sperm in the epididymis underwent longitudinal-2-suture intussusceptive vasoepididymostomy (LIVES). And for those with sperm in the epididymal head only or with bilateral obstruction or absence of the vas deferens in the distal epididymis, the sperm were collected and subjected to cryopreservation for intracytoplasmic sperm injection (ICSI). After surgery, the patients were followed up for observation of the semen parameters and the rate of pregnancy.</p><p><b>RESULTS</b>Of the total number of patients, 53 (92.9%) were diagnosed with epididymal OA by scrotal exploration, 47 (82.5%) underwent microsurgery, and the other 10 (17.5%) received sperm cryopreservation. At 1 to 18 months after surgery, motile sperm were found in the ejaculate in 46.8% of the cases (22/47), natural pregnancy in 10.6% (5/47), and ICSI pregnancy in 18.5% (6/32).</p><p><b>CONCLUSION</b>With the development of microsurgery, non-invasive means should be the first choice for the diagnosis of OA. And surgical exploration can be employed to determine the location of obstruction and the option for treatment.</p>