Penile Torsion Repair By Suturing Tunica Albuginea To The Pubic Periosteum

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 28 Feb 2006 - 11:00 PST

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Penile torsion can present as its own entity or in conjunction with hypospadias and/or chordee. Some believe that it results from abnormal skin attachment during development. Several authors have described different techniques: (1) degloving the penis and reattaching the skin to repair penile torsion; (2) removing angular ellipses of corporeal tissue with subsequent application to repair this condition; and (3) using a dorsal dartos flap rotation. The aim of the study by Zhou et al was to evaluate the effectiveness of a new technique to repair penile torsion in children by suturing the right tunica albuginea with 2-0 silk to the pubic periosteum near the junction of shaft and root of right corporal body, at a point where counter-rotation can be achieved.

The study included 18 boys with penile. Eleven had associated hypospadias, 4 had chordee without hypospadias, and 3 had torsion only. The direction of rotation was counterclockwise in 16 cases and clockwise in 2 cases. Torsion was repaired in 6 patients by degloving the penis and reattaching the dartos and the skin (comparative group). In 11 patients (1 with prior repair), the torsion was corrected by suturing the lateral edge of the corpus cavernosum to the pubic periosteum (study group). Two patients were not treated. The follow-up ranged from 6 months to 7 years. All of the 11 cases in the study group had satisfactory correction of the penile torsion. All of the urethroplasties for hypospadias were successful. In the comparative group, none of 6 patients had satisfactory correction of the rotation.

The group concluded that their technique of degloving the penis and reattaching the skin couldn't reliably correct penile torsion. They found that lateral suturing of tunica albuginea to the pubic periosteum to repair penile torsion appeared to be a better technique in their hands. They were able to adjust the correcting angle during the operation and achieve a complete and accurate correction of the rotation.

Written by: Pasquale Casale MD

Reference: Zhou L, Mei H, Hwang AH, Xie H, Hardy BE.

Penile Torsion Repair By Suturing Tunica Albuginea To The Pubic Periosteum.

Journal of Pediatric Surgery 41(1): 7-9, January 2006.

Link Here.
Zhou L, Mei H, Hwang AH, Xie HW, Hardy BE

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