Degloving and realignment--simple repair of isolated penile torsion.
OBJECTIVE
To present the results of repairing congenital or acquired penile torsion by means of a simple surgical procedure that does not involve resection of corporeal tissue.


METHODS
Forty-six circumcised patients (mean age 27 months, range 6 to 119) presented with isolated penile torsion of a greater than 30 degree rotation. The surgical technique involved degloving the penile skin to the penoscrotal junction. Residual torsion was corrected using 5-6/0 polyglactin absorbable suture applied to the desired 12-o'clock position of the penile skin adjacent to the glans and to a location counter to the direction of the torsion in the degloved penile skin sleeve. A wedge of loose ventral penile skin was usually resected. The resultant tightening of the skin allowed for proper alignment of the penis and better cosmesis. The rest of the circumferential incision was closed using the same suture material. The success of the procedure was evaluated according to physician and parental satisfaction with the final outcome.


RESULTS
Thirty-seven patients were available for follow-up (mean 31 months, range 8 to 68). Satisfactory results were achieved in 35 (95%) of the 37 patients; the other 2 had residual torsion. Complications were minor and consisted of postoperative fever and a subcutaneous hematoma in 1 patient that resolved with conservative treatment.


CONCLUSIONS
The degloving and realignment procedure is a simple technique that may be applied safely and successfully in most cases of penile torsion.
Bar-Yosef
Yuval
Y
Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel. yuvalbary@hotmail.com
Binyamini
Joseph
J
Matzkin
Haim
H
Ben-Chaim
Jacob
J
D002675:Child, Preschool; D002944:Circumcision, Male; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010409:Penile Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013536:Suture Techniques; D014102:Torsion Abnormality / Q000151:congenital / Q000601:surgery; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*