title: [Successive "Z" incision and skin flaps: a better procedure for penile lengthening].
abstract: OBJECTIVE
  To recommend the successive "Z" incision and skin flaps as a method for repairing the wound in penile lengthening procedures.
  
  
  METHODS
  We performed penile lengthening surgery by successive "Z" incision for 5 patients complaining of short penis, who ranged in age from 16 to 34 years (22.4 +/- 7.2), and 3 of whom had a history of urethroplasty, circumcision and penile reconstruction, respectively. The superficial suspensory ligament and part of the deep suspensory ligament of the penis were exposed and severed to release the penis, and the "Z" skin flaps sutured in a tensionless state. Drainage was necessitated by exudation and the catheter removed in 24-48 hours. The penis was wrapped up by an elastic bandage, and the stitches taken out 8-10 days after the operation.
  
  
  RESULTS
  We achieved a mean erectile length of 8.4 cm (range 7.8-9.2 cm) after the operation, as compared with 4. 8 cm (range 4.0-5.8 cm) before the surgery. Two students of the patients obviously became active and confident. No penile contraction was noted during the 12-48 months follow-up, and both the patients and their family members were satisfied with the outcomes.
  
  
  CONCLUSIONS
  Compared with the V-, M- and Z-incision, the successive "Z" incision and skin flaps can yield longer penile length, solve the problem of insufficient skin flap to cover the wound and reduce such complications as skin necrosis and infection. It is well worth recommending for patients complaining of short penis because of penile abnormality, post-operation scar on the penis or circumcision.
authors.affiliation: Department of Andrology, Nanjing University School of Clinical Medicine/Nanjing General Hospital of Nanjing Military Region, Nanjing, Jiangsu 210002, China.
authors.forename: Lian-Jun
authors.initials: LJ
authors.lastname: Pan
authors.forename: Li-Jie
authors.initials: LJ
authors.lastname: Zhu
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.forename: Zhi-Kang
authors.initials: ZK
authors.lastname: Cai
authors.forename: Jun
authors.initials: J
authors.lastname: Da
authors.forename: Guo-Qin
authors.initials: GQ
authors.lastname: Dong
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010413:Penis / Q000002:abnormalities / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome