Isolated torsion of the penis: technique and review of the literature

ABSTRACT

Torsion of the penis is a rather rare condition in which the penis is rotated to one side with different degrees. It is a common condition when associated with other congenital defects of the penis such as hypospadias and epispadias and their variants. The association of chordee and bending of the penis is a common happening. This study in meant to demonstrate a new technique in the treatment of Torsion of the penis. Among the cases admitted to the Paediatric Surgical Unit of the Medical Research Institute and of the Faculty of Medicine-University of Alexandria, 18 cases of isolated torsion were included in this study. These were gathered based on consecutive admission in the period between March 2001 and February 2003. A total of 11 cases were admitted in the Faculty of Medicine Unit, while 7 cases were managed in the Medical Research Institute. The age ranged between 1 and 10 years with a mean of 4.4 years. The cases associated with hypospadias and epispadias were not included in this study. However, some deviation of the isolated cases of torsion included 1 case with chordee, 1 case of lateral bent penis and 2 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases in 2002 and 3 cases in 2003, Fifteen out of the 18 cases were showing an anti-clokwise torsion. Simple detorsion under general anaesthesia was the rule using a modification to adjust the shape of the penis after circumcision. This depends on protection of the glans and determination of the ratio between the post-coronal collar and the skin in anticipation. Adequate apposition of the median raphe to the new de-roted shaft is put in consideration. No complications were encountered except in one case, where residual torsion was reported after healing. Another go was necessary to ensure satisfactory detorston