RU-2861358-C1 - METHOD FOR TREATING COMPLICATION ASSOCIATED WITH SKIN DEFICIENCY AFTER CIRCUMCISION SURGERY

RU2861358C1RU 2861358 C1RU2861358 C1RU 2861358C1RU-2861358-C1

Abstract

FIELD: medicine; operative urology. SUBSTANCE: invention is intended for surgical correction of complications associated with skin deficiency of the penile shaft after previously performed surgical interventions. The skin is incised ventrally along the midline to the middle part of the scrotum. Triangular, full-thickness flaps are cut from the scrotal skin, as shown in fig. 1 (4). The flaps are mobilised and raised to the coronal sulcus, and the skin defect of the penile shaft is covered with the formed flaps by suturing corresponding edges with interrupted sutures. EFFECT: eliminating the complication in one stage, reducing operation time from 90-120 to 60 minutes, reducing the number of postoperative complications. 1 cl, 1 dwg, 3 ex

Inventors

KOZYREV German Vladimirovich
Murtuzaliev Zaur Nurulaevich
Abdulkarimov Gamzat Alievich

Dates

Publication Date: 20260505
Application Date: 20250807

Claims (1)

A method for treating a complication associated with a skin deficiency following circumcision surgery, which involves covering a skin defect on the shaft of the penis, characterized in that the skin is incised ventrally along the midline to the middle part of the scrotum, triangular, full-thickness flaps are cut out from the skin of the scrotum, as shown in Fig. 1 (4), the flaps are mobilized and elevated to the coronal groove, and the formed flaps are used to cover the skin defect of the shaft of the penis by suturing the corresponding edges with interrupted sutures.

Description

The invention relates to medicine, namely to urology, and is intended for the surgical correction of complications associated with a deficiency of the skin of the penis shaft after previous surgical interventions. Analogues There are various methods for closing a skin defect on the penile shaft. These include the Sapozhkov-Reich procedure and an operation using a free skin autograft (Operative Urology. Manual for Physicians. 1986, p. 341). Criticism of the analogy However, these alternatives don't always satisfy practicing urologists, as they have certain drawbacks. These include the need for staged surgeries, necrosis of the transplanted free skin flap, and cosmetic defects after surgery. Prototype We chose the two-stage Sapozhkov-Reich operation as our prototype. The prototype method consists of the following: a circular incision behind the coronal sulcus is made to free the penis, and the corpora cavernosa are mobilized. The scalped portion of the penis is passed through the formed scrotal skin tunnel, leaving the glans penis exposed at the scrotal fundus. The second stage of the operation, 3-6 months later, frees the penis, covered by scrotal skin, and creates a penoscrotal angle. The scrotal skin defect is closed with local tissue. Criticism of the prototype The prototype's disadvantages include the need for two major surgical procedures to cover the skin deficiency on the penile shaft. Consequently, the risk of various postoperative complications increases. Potential complications include bleeding, the formation of large hematomas with the risk of suppuration, penile deformity, and cosmetic defects due to postoperative scarring. Purpose of the invention The aim of the invention is to correct penile shaft skin deficiency in a single operation, preventing complications seen with other surgical techniques without the need for repeat interventions. The essence of the invention The essence of the operation is illustrated in Fig. 1, where pos. 1 is a circular incision of the skin behind the coronal groove, pos. 2 is mobilization of the cavernous bodies, pos. 3 is cutting out full-layer skin flaps from the skin of the scrotum, pos. 4 is covering the cavernous bodies with the formed skin flaps, pos. 5 is the view of the penis after the operation. Due to a skin deficiency on the penile shaft, a ventral midline skin incision is made to the midscrotum. Triangular, full-thickness flaps are dissected from the scrotal skin. The flaps are mobilized and elevated to the coronal sulcus. The resulting flaps are used to close the penile shaft skin defect by suturing their edges with intersecting triangular flaps and interrupted sutures. This method avoids the need for repeat surgeries and reduces the risk of various postoperative complications. A circular skin incision is made behind the coronal sulcus of the penis. A ventral midline skin incision is made to the midscrotum. Triangular, full-thickness flaps are dissected from the scrotal skin, incorporating the tunica dartos. The flaps are mobilized and elevated to the coronal sulcus. The resulting flaps are used to close the penile shaft skin defect by suturing their edges with intersecting triangular flaps and interrupted sutures. Examples of specific implementation of the proposed method Example 1 Patient L., 4 years old, underwent circumcision at 5 months of age. Local examination revealed a significant decrease in penile size due to a skin deficiency on the penile shaft. The penis is recessed and fixed in the pubic area. The surgical procedure was performed using the proposed technique: a circular skin incision is made behind the coronal sulcus of the penis. The skin is dissected ventrally along the midline to the midscrotum. Triangular, full-thickness flaps (including the tunica dartos) are dissected from the scrotal skin. The flaps are mobilized and elevated to the coronal sulcus. The resulting flaps are used to close the penile shaft skin defect by suturing their edges with opposing triangular flaps and interrupted sutures. No early or late postoperative complications were observed. The surgical results were assessed at 1, 3, and 6 months. The penis is within normal age limits, with no skin defects or deformities. Example 2 Patient M., 5 years old, previously underwent two surgeries for penile shaft hypospadias. Examination revealed ventral deformity of the penis due to scarring of the penile shaft. The external urethral orifice is located in the coronal sulcus. The surgical intervention was performed using the proposed technique with simultaneous plastic surgery of the glans urethra. No early or late postoperative complications were observed. The surgical results were assessed at 6 and 12 months. The penis is within the normal age range, with no skin defects or deformities. The external urethral opening is located in a typical location. Example 3 Patient A., 7, underwent surgery for a hidden penis at the age of 3. Upon examination, the penis was visually reduced