ABSTRACT
Objecive@#To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting.@*Methods@#From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied.@*Results@#In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001).@*Conclusions@#This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.
ABSTRACT
Objective@#To explore the feasibility and applicability of a novel cavernosum-free surgical technique for concealed penis of children.@*Methods@#From June 2017 to August 2017, 38 boys with concealed penis were treated using our new cavernosum-free surgical technique. The median age was 8.5 years(4-13 years). The technique consisted of 3 steps: Step 1, making a horizon incision and expose the glans; Step 2, suturing skin of penis to the corresponding side of inguinal ligament medial crus at 2 and 10 o′clock without fixing of cavernosum.Step 3, pruning the foreskin and suturing together. No catheter was placed after surgery.@*Results@#All the patients were able to urinate 2 to 6 hours after operation. The numeric rating scales score of postoperative pain was 1-3. Wound dressing was removed 5 to 7 days post-operatively. All of the parents had good cosmetic appearance, penis stretched naturally without deflection. The length of penis increased more than 3.0 cm on average after operation.Edema was observed in 3 cases, but disappeared in 5-7 days.No serious complications such as bleeding or winding occurs.@*Conclusions@#The novel cavernosum-free surgical technique is easy to perform. It provides a safe and effective technique for concealed penis of children.
ABSTRACT
Objective@#To sum up the clinical manifestations and the method for repairing of secondary deformities of postoperation of hypospadias.@*Methods@#Applying balanus tissue flaps and urethral meatus plastic could correct the flat balanus and prevent urethral meatus from falling back. Resecting scar completely in penis and rebuilding urethral tissues could treat secondary curved penis. Applying modified penile augmentation which involved girth enhancement by a free dermal-fat graft and penile elongation (suprapubic skin advancement-ligamentolysis) could correct shorter and much smaller penis.@*Results@#Among January 1st 2007 to December 31st 2016, 62 cases were treated.All of them were male. Their ages were from 14 to 34 years old.55 cases were followed up from 6 months to 9 years after operations, but 7 cases could not be followed up because of the change of addresses and phone numbers.All patients achieved excellent cosmetic result. None of them had complications like urethral fistula.@*Conclusions@#After operations of hypospadias, the secondary deformities may happen when the children grow up.And these deformities always need to be corrected with operations. Balanoplasty, correction of penis and the penile augmentation are good methods for secondary deformities.Consequently, a good penis appearance and function can be acquired.