Penoplasty with T-shaped incision and three-point fixation for concealed penis / 中华男科学杂志

<p><b>Objective</b>To search for a safe and effective method of penoplasty with low incidence of complications for concealed penis by evaluating penoplasty with T-shaped incision and three-point fixation in comparison with modified Devine's technique.</p><p><b>METHODS</b>We retrospectively analyzed 169 cases of concealed penis treated in our center by penoplasty with T-shaped incision and three-point fixation (group A, n = 110) or modified Devine's surgery (group B, n = 59). We compared the operation time, postoperative complications, and recurrence rate between the two groups of patients.</p><p><b>RESULTS</b>Operations were successfully completed in all the cases, the urinary catheters removed at 3 days and the elastic bandages applied for 2 to 4 weeks. The patients were followed up for 4 to 12 months. The penis was satisfactorily exposed. The operative time was significantly shorter in group A than in B (［52.8 ± 6.9］ vs ［61.5 ± 10.6］ min, P < 0.001), the postoperative complication rate was obviously lower in the former than in the latter (prepuce edema: 17.27% ［19/110］ vs 33.89% ［20/59］, P = 0.021; bleeding: 0.90% ［1/110］ vs 3.38% ［2/59］, P = 0.552; skin necrosis: 0.90% ［1/110］ vs 5.08% ［3/59］, P = 0.123; skin infection: 0.90% ［1/110］ vs 5.08% ［3/59］, P = 0.123), and so was the recurrence rate (0.90% ［1/110］ vs 6.77% ［4/59］, P = 0.032).</p><p><b>CONCLUSIONS</b>Penoplasty with T-shaped incision and three-point fixation deserves to be popularized clinically for its advantages of minor invasion, clear exposure, reliable penile fixation, low incidence of postoperative complications and recurrence, and satisfactory outcomes.</p>

Excision of skin tumors through T-shaped incision

Conventional removal of benign skin tumors with transverse or elliptical excision often results in depression, considerable dog ear formation and lengthening of the final scar. The resulting scar is always longer than the maximal diameter of the elevated skin tumor. Curvilinear transverse incision was designs on the center of the skin tumor, then on the center of transverse incision, the vertical limb incision was added to complete T-shaped incision. After local anesthetic solution was infiltrated through the designed lines, the mass was completely removed. To obliterate dead space, the mid point of the incision was approximated with a suture; there remained dog ears on both sides. To remove the dog ears, triangular flaps were advanced anteromedially, excised, and sutured. Resection of the skin tumors through T-shaped incision provides easy dissection, simultaneous dog ear and dead space repair and elimination of depression of the skin lesion site. To predict the length of the vertical limb incision, it was measured intraoperatively, the length of the vertical limb incision was ranged from 30% to 41% of the transverse incision. So, initially the length of the vertical limb incision was safely designed to remove dog ears and depression from one third of the transverse incision.