Ladder step strategy for surgical repair of congenital concealed penis in children / 中华男科学杂志

<p><b>Objective</b>To assess the feasibility of the ladder step strategy in surgical repair of congenital concealed penis in children.</p><p><b>METHODS</b>This study included 52 children with congenital concealed penis treated in the past two years by surgical repair using the ladder step strategy, which consists of five main steps: cutting the narrow ring of the foreskin, degloving the penile skin, fixing the penile skin at the base, covering the penile shaft, and reshaping the prepuce. The perioperative data of the patients were prospectively collected and statistically described.</p><p><b>RESULTS</b>Of the 52 patients, 20 needed remodeling of the frenulum and 27 received longitudinal incision in the penoscrotal junction to expose and deglove the penile shaft. The advanced scrotal flap technique was applied in 8 children to cover the penile shaft without tension, the pedicled foreskin flap technique employed in 11 to repair the penile skin defect, and excision of the webbed skin of the ventral penis performed in another 44 to remodel the penoscrotal angle. The operation time, blood loss, and postoperative hospital stay were 40－100 minutes, 5－30 ml, and 3－6 days, respectively. Wound bleeding and infection occurred in 1 and 5 cases, respectively. Follow-up examinations at 3 and 6 months after surgery showed that all the children had a satisfactory penile appearance except for some minor complications (2 cases of penile retraction, 2 cases of redundant ventral skin, and 1 case of iatrogenic penile curvature).</p><p><b>CONCLUSIONS</b>The ladder step strategy for surgical repair of congenital concealed penis in children is a simple procedure with minor injury and satisfactory appearance of the penis.</p>

Changes in Sexual Function after the Midurethral Sling Procedure for Stress Urinary Incontinence: Long-term Follow-up / 대한배뇨장애요실금학회지

PURPOSE: It is known that 50% to 68% of women with stress urinary incontinence (SUI) have sexual function impairment and avoid sexual intercourse. Reports of sexual function after SUI surgery vary, with reports of both improved function and deteriorated function. The goal of this study was to evaluate the impact of midurethral sling procedures on the sexual function of women suffering from SUI preoperatively and 36 months postoperatively. MATERIALS AND METHODS: Among 75 patients who were diagnosed with SUI and underwent the midurethral procedure, 47 patients who answered the Korean version of the Female Sexual Function Index (FSFI) Questionnaire were analyzed prospectively. The retropubic route (RPR) was used in 26 patients, whereas the transobturator route (TOR) was used in 21 patients. Fifteen patients underwent concomitant posterior colporrhaphy. The FSFI was completed before surgery and 36 months after surgery. RESULTS: The patients' mean age was 44.9 years (range, 30-59 years) and their mean parity was 2.8 (range, 0-6). There were no significant differences in the individual FSFI domain scores between before surgery and 36 months (36.8+/-4.57) after surgery. There were no significant differences in sexual satisfaction between the patients with concomitant posterior colporrhaphy and patients with the midurethral sling procedure only. There were no significant differences in domain score between the TOR and the RPR, but patients experienced less pain after the RPR than after the TOR. CONCLUSION: There was no significant change in overall sexual function in women undergoing the midurethral sling procedure. Attention must be paid when performing the TOR procedure because it can cause pain during intercourse.

What is the best Treatment of Penile Fractures? Conservative or Surgical?: Experience in 34 cases / 대한남성과학회지

PURPOSE: Penile fracture is described as a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. In this study, we aimed to compare conservative and surgical treatment modalities. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 34 patients who visited our hospital with penile fracture and two treatment modalities were compared: conservative (Group I) and surgical (Group II). The five men who refused surgical treatment were treated conservatively, and the other 29 patients underwent surgical treatment. RESULTS: The most common cause of fracture was sexual intercourse (21/34, 61.8%). The most common sites of fracture were the right (67.6%), ventral (67.6%), and proximal (47.1%) parts of the penis. In Group II, only complication was painful erection (2/29, 6.9%), whereas in group I, 80% (4/5) suffered complications such as wound infection, painful erection, penile nodules with curvature, and erectile dysfunction. All patients treated with surgery successfully recovered without erectile dysfunction. CONCLUSIONS: Because surgical management gives excellent results, shorter hospitalization, less morbidity, surgical treatment is more effective approach than conservative treatment.

Penile torsion correction by diagonal corporal plication sutures

Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is described to effectively solve this problem.