Congenital Isolated Penile Torsion and Simple Surgical Repair in Children

Abstract

Objective: We aimed to determine the prevalence of congenital isolated penile torsion and to present the results of correction by a simple surgical technique.

Materials and Methods: Between 2016 and 2019, 2650 boys who presented circumcision request were evaluated in terms of congenital isolated penile torsion in our clinic.They were classified in terms of the degree and direction of torsion, and their clinical complaints were investigated. Circumcision and degloving were performed to patients that its had 45 degrees or more torsion. Raphe was left in its original position, and torsion was corrected by frenulum-skin realignment. Results were evaluated.

Results: Congenital isolated penile torsion of >45° was reported in 1.2% (n=32) boys. The direction of torsion was to the left in 93.8% (n=30) and to the right in 6.2% (n=2) patients. Moreover, 37.5% (n=12) patients had complaints of torsion in the penis, and three patients of school age had complaints of sideways-pointing urine stream. Ecchymosis, which resolved itself, was observed in 9.3% (n=3) of the postoperative patients. No patients had residual torsion.

Conclusion: The prevalence of congenital isolated penile torsion was in 1.2% (>45°) boys. The method of degloving and frenulum-skin realignment leaving the raphe in its original position is a safe and simple method that can be performed to correct all torsions. 

Keywords

• children
• prevelans
• surgical correction
• penile torsiyon

Çocuklarda Konjenital İzole Penil Torsiyon ve Basit Cerrahi Onarımı

Öz

Amaç: Amacımız konjenital izole penil torsiyon prevalansını saptamak ve basit bir teknik ile onarım sonuçlarını sunmaktır.

Materyal ve Metot: Kliniğimize sünnet istemiyle 2016 ile 2019 yılları arasında başvuran 2650 erkek çocuk konjenital izole penil torsiyon açısından değerlendirildi.Torsiyon derecesi ve yönüne göre sınıflandırıldı ve klinik bulguları incelendi. Torsiyon derecesi >45 derece olan hastalara sünnet ve degloving uygulandı. Raphe mevcut konumunda bırakılarak frenilum-cilt yeniden hizalama ile torsiyon düzeltildi. Sonuçlar değerlendirildi.

Bulgular: Çocukların %1,2 (n=32)’sinde >45° konjenital izole penil torsiyon tespit edildi. Torsiyon yönü %93,8 (n=30) hastada sola, %6,2 (n=2) hastada sağa idi. Hastaların %37,5 (n=12)’inde peniste eğrilik, okul çağındaki üç hastada peniste eğrilik ve yana işeme şikayeti vardı. Ameliyat sonrası hastaların %9,3 (n=3)’ünda kendiliğindendüzelen ekimoz görüldü. Hiçbir hastada rezidü torsiyon görülmedi.

Sonuç: Çocuklarda >45° izole penil torsiyon oranı %1,2 idi. Raphe mevcut konumunda bırakıldığında basit ve güvenli bir yöntem olan degloving-cilt yeniden hizalama ile tüm torsiyonlar düzeltilebilir.  

Anahtar Kelimeler

• cerrahi onarım
• çocuk
• penil torsiyon
• prevelans

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