The concealed penis: the "two-corner" surgical technique

Analysis of the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis

OBJECTIVE

This study aimed to analyze and explore the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis.

METHODS

A total of 76 eligible patients with concealed penis were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group received integrated medical and nursing care intervention. Outcomes include pain levels, comfort status, incidence of complications, and nursing satisfaction were collected and analyzed to investigate the nursing effects of the integrated medical and nursing care model.

RESULTS

After 2/3 days of nursing intervention, the patients in the observation group had significantly lower pain scores (measured by FPS-R) compared to the control group (P < 0.05). The patients in the observation group also had significantly higher comfort scores (measured by Kolcabal) compared to the control group (P < 0.05). The incidence of complications in the observation group was significantly lower than that in the control group (2.63 vs. 23.68, P < 0.05). Parental satisfaction in the observation group was significantly higher than that in the control group (P < 0.05).

CONCLUSION

The integrated medical and nursing care intervention in correction surgery for children with concealed penis demonstrated positive nursing effects. It effectively reduced pain, improved comfort, lowered the risk of complications, and increased parental satisfaction. This approach maximizes the role of nursing care and is recommended for clinical implementation.

Two levels vs. one level of phallopexy in the treatment of concealed penis in patients in pediatric age group

INTRODUCTION

Concealed penis, which is the congenital type of buried penis, is a condition in which a normal-sized penis is totally or partially hidden by pubic, scrotal, or thigh skin. Several procedures had been described for its correction including phallopexy, that is, fixation of penile Buck's fascia to the sub-dermis.

AIM OF THE WORK

Our work aims to study the difference in outcome between performing phallopexy at one level and at two levels.

MATERIAL AND METHODS

Our study included 180 uncircumcised patients who had a concealed penis while having an average length of an outstretched penis. These patients were divided into two groups: the first one was treated with one level of phallopexy at the 3 and 9 o'clock points, while the second group was treated with the same procedure in addition to another level of stitches at the mid-penile level. The follow-up was carried out for one post-operative year regarding penile skin edema, infection, congestion, necrosis, and/or re-retraction.

RESULTS

The overall success rate was 96.1% for a normally-looking penis without post-operative re-retraction. Re-retraction developed in two patients (2.2%) of those who had one-level phallopexy and in five patients (5.6%) of those who had two-level phallopexy without statistical significance (^FE p = .444). Penile skin edema developed in 76 patients (42.2%) being significantly lower in patients with lower body weight (p = .030*).

CONCLUSION

Phallopexy could be performed safely in the case of the concealed penis with satisfactory results. Two levels of phallopexy did not add any advantage to the post-operative results besides the fact that this may be demanding, time-consuming, and may require higher resources, so we recommend the easier one-level phallopexy in the treatment of such conditions with satisfactory results.

The Characteristics and Distribution of Nerve Plexuses in the Dartos Fascia From Concealed Penis Children

The purpose of this study is to analyze the nerve plexus distribution in dartos fascia of concealed penis (CP). A total of 28 CP patients met ASA categories I and II were included, with median age of 3.5 years (8 months-5 years). During the surgery, tissue samples of dartos fascia at points 3, 6, 9, and 12 o'clock of the penile shaft were collected. Standard hematoxylin and eosin (H&E) staining and S-100 immunohistochemical staining were used to analyze the nerve plexus distribution among different positions. The number of nerve plexuses in superficial fascia collected at the 6 o'clock position of the penile shaft was the most abundant among four positions (median 7.25, range 1-24). The abundant nerve plexuses in the dartos fascia of CP patients, especially at the 6 o'clock position, indicate that the surgery on the preputial frenulum should avoid damage to the dartos fascia, as it might be related to maintain the erection and sexual function in adolescence.