Best time for occult phimosis surgery

Occult phimosis surgery is a common surgery in medicine, which can usually be used to treat the problem of phimosis of male reproductive organs. Surgery can effectively improve the phimosis condition, remove excess foreskin, and restore the penis to a normal state. Under normal circumstances, occult phimosis surgery needs to be performed at a certain age, and can usually be started during childhood.

Best time for occult phimosis surgery

The best time to perform occult phimosis surgery is during childhood.

method

Hidden penis is a common congenital developmental abnormality and malformation disease, also known as buried penis. In hidden penis, the penis is retracted inside the body, with only the pointed foreskin protruding outside. If you squeeze the penis skin inward with your hands, the penis will be exposed, and if you release your hands slightly, the penis will retract. Although hidden penis looks similar to prepuce hyperplasia, they are two completely different diseases.

treatment

There is a great deal of controversy over the treatment and surgical age of cryptic penis. If the foreskin can be turned up to expose the glans penis, surgery is not necessary, and cryptic penis gradually improves with age. The purpose of the surgery is to expand the foreskin opening and expose the glans penis. Be careful not to do a simple circumcision. Surgical method: ① Make a circular incision along the foreskin opening, and cut the outer plate about 1.5 cm along the 2, 6, and 10 points; ② Make a longitudinal incision of 1.5 cm along the 4, 8, and 12 points on the inner foreskin, turn the foreskin outward, and the glans penis can be smoothly exposed; ③ Suture the inner and outer foreskin in the shape of an embedded skin flap. The key points of this operation are as follows: the inner and outer layers of the foreskin are incised longitudinally in a staggered manner, and the incisions are sutured in the shape of an inlaid skin flap. The operation enlarges the foreskin opening.

Another surgical method: try to evert the foreskin, make a narrow longitudinal incision at 10 o'clock and 2 o'clock to make the foreskin evert and expose the glans penis. Make a circular incision of the inner plate 0.8-1.0cm away from the coronal sulcus, and trim and suture the foreskin.

Since the characteristics of the concealed penis are that there are fewer outer plates and more inner plates9, the dorsal skin of the penis is short and the ventral skin is long, it is sometimes necessary to turn the ventral pedicled skin flap to the dorsal side to repair the damaged skin.

Causes

Concealed penis is a congenital malformation caused by abnormal development of the tunicum pubis. It is different from the situation in which fat accumulates at the base of the mons pubis and scrotum due to obesity, and the penis is hidden deep under the skin. The latter can return to normal after maturation and reduction of fat tissue. Concealed penis patients have abnormal development of the tunicum pubis, and the loose and elastic tunicum becomes inelastic, thick fibrous fascia, and sometimes forms cords. These abnormally developed fascia and cords pull the penis proximally and constrain it below the pubic symphysis.

Clinical manifestations

Hidden penis is caused by the foreskin not being attached to the penis body. If you hold the penis with your fingers and push the skin around it back, the penis hidden under the skin can be revealed. As the child grows, the subcutaneous fat decreases and the penis can be exposed. If the foreskin cannot be turned up to expose the glans penis, it means that there is phimosis and a phimosis surgery is performed.

Differential diagnosis

It should be distinguished from micropenis, penile dysplasia and phimosis. The first two are caused by endocrine defects or chromosomal abnormalities. Clinically, the penis is small, erections are rare and weak. The latter is caused by the narrow foreskin opening, which makes the glans penis unable to be exposed.