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Hidden penis
Last reviewed: 23.04.2024
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Another unresolved problem in pediatric urology is the so-called hidden penis. In this problem, the social aspect rather than the functional question dominates.
Adult patients with a concealed penis have a cosmetic defect, but neither the act of urination nor their sexual life is usually violated, except when the anomaly is combined with phimosis.
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To date, there is no single point of view on the classification of this pathology, since some urologists generally consider this pathology an option for the development of the penis and accordingly do not perform any surgical intervention. From the point of view of most urologists, the latent penis is a malformation of the male genitalia, requiring in the vast majority of cases a surgical correction.
In most clinics, a classification of this pathology has been developed and implemented.
A truly concealed penis, in which there is a pronounced skin deficit of the actual phallus, a distally located suspension of the phallus ligament and a short sagging ligament.
"Caught" penis, in which there is some deficiency of the outer skin of the penis in combination with the stenosis of the foreskin, which, in fact, leads to a situation of a drowned phallus.
Secondary latent penis - as a manifestation of general obesity, while fatty tissue of the pubic region shifts the skin and looks like a corrugated tissue, and at the time of erection, the phallus expands almost completely.
Combined vice, in which a combination of the three above options is possible.
Combined variant of developmental malformation with hypospadias, epispadias, cryptorchidism, inguinal hernia, etc.
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Treatment of the latent penis
In the vast majority of cases, surgical intervention with the third form of malformation is not shown. Only in exceptional situations - at the urgent request of the patient for the purpose of optimal adaptation of it in society - it is necessary to perform the operation.
Operative intervention begins with a bordering incision around the head of the penis, after which they fully mobilize the skin to the penisymmetric angle and cross a ligament suspending the phallus (lig. Suspensorium penis) and the sinus ligament. Then on 9 and on 3 hours of the conventional dial from the inside, two nodal seams are placed between the white membrane of the withdrawn cavernous bodies and the skin of the penis at the border of the skin of the trunk itself into the scrotum. For this purpose, a monofilament non-absorbable suture material is used. The internal sheet of the foreskin is split and covered by the mobilized cavernous bodies by the skin itself.
The latent penis with the second form is treated by eliminating the scar of the foreskin, preventing the head from leaving the entire trunk.
The most problematic is the hidden penis of the first variant. The true deficit of the skin of the trunk in some cases does not allow to solve the problem overnight. Sometimes surgeons are forced to resort to the use of hormonal therapy in order to increase the stock of plastic material. To do this, use a dihydrotestosterone gel in the form of applications, which allows a short period (3-4 weeks) to build up enough skin folds for plastic phallus.
After several weeks of using hormonal applications, the operation described above is performed.
In the postoperative period, urine is removed using a urethral catheter for 5-7 days. Also use a compression bandage, sowing is recommended for up to 6 months because in this case it performs a fixing role. In adult patients for this purpose, use special penial expostors, used for 4 hours a day for 6 months.