| Objective: Concealed penis is a common congenital malformation in children’s urinary system.It refers to the disease in which the penis has a normal Corpus cavernosum,but its exposure length is shorter than normal people due to the lack of penile skin.At present,there is no common standard for indication,timing and effect evaluation of the operation for concealed penis.In order to draw meaningful conclusions and provide better suggested age and methods for surgery,this study mainly evaluates three aspects,including postoperative complications,psychological changes and satisfaction changes.Materials and Methods: The information is collect from patients who received concealed penis surgery in our hospital during the period of January 2017 to January2019.These patients were diagnosed by pediatric urologist.All patients were excluded from trapped penis,webbed penis,small penis,simple obese concealed penis and with other penile malformations(such as hypospadias).According to Tanner’s stage,the patients were divided into two stages.The patients basic information and follow-up data were collected through network and clinic appointment,all statistical was analysis by SPSS.Results: The information is collect from 50 follow-up surveys of patients who received concealed penis surgery in our hospital during the period of January 2017 to January2019.The follow-up time was 13 days to 707days(average 321.08 ±187.74 days);the length of penis exposure increased 0.35 cm(median,range:-2～+4);the short-term complications occurred rate is 94%,26 cases of grade I,16 cases of grade II and 5 cases of grade III,among them,38 cases(76%)had prepuce edema,15 cases(30%)had penile scar formation,4 cases(8%)had erectile difficulty,the glans could not be completed total exposure in 1 case(2%)and penile retraction in 1 case(2%).Satisfaction score of 1 month after operation was 17 points(±1.41),3 months after operation was 13.4 points(±3.58),and 1 year after operation was 14.58 points(±3.73);30 cases(60%)were satisfied with the results of the operation,46 cases(92%)were willing to recommend the operation to relatives or friends with similar diseases.Postoperative efficacy score of the operation was 5.44 points(±1.36,full score 7 points);36 patients aged 0-9 years had a preoperative psychological score of 8.47 points(±4.76)and 13.42 points(±3.45)after operation(p < 0.01);14 patients over 9 years old had a preoperative psychological score of 7.79 points(±3.97),and 15.64 points(±2.93)after operation(p < 0.01).Conclusion: As the age of concealed penis patients increases,there are different degrees of psychological changes in children.Therefore,for the patients who cannot turn up the foreskin,it is suggested that surgery be performed as soon as possible,rather than waiting for puberty.There are many concealed penile operation methods,although there is no clear evidence that whether or not the penis retracts after operation is related to the root fixation,it is still recommended that root fixation be performed during the operation to avoid the occurrence of penile retraction.There was possibly negative correlation between postoperative pressure bandaging and edema disappearance time.Surgery can significantly change the satisfaction and psychology of patients or parents.Postoperative satisfaction is the highest in one month.With the increase of time,satisfaction decreases and then gradually increase. |
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