Penile disassembly technique by Perovic for epispadias repair
Introduction: Bladder exstrophy remains one of the most challenging and complex congenital conditions in pediatric urology. Various techniques have been described to reconstruct penile anatomy, yet a high risk of complications remains [1-5]. There is a limited number of articles dedicated to the use...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Urology Video Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089722000330 |
| _version_ | 1817980414173642752 |
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| author | Dina Manasherova German Kozyrev Sergei Yatsik Rados Djinovic |
| author_facet | Dina Manasherova German Kozyrev Sergei Yatsik Rados Djinovic |
| author_sort | Dina Manasherova |
| collection | DOAJ |
| description | Introduction: Bladder exstrophy remains one of the most challenging and complex congenital conditions in pediatric urology. Various techniques have been described to reconstruct penile anatomy, yet a high risk of complications remains [1-5]. There is a limited number of articles dedicated to the use of penile disassembly technique by Perovic.In the presented video, our objective was to demonstrate the improved penile disassembly by Perovic technique. Material and methods: A 23-year-old male patient presented to the clinic after 5 unsuccessful penile surgeries with dorsal penile curvature and meatus located dorsally. With a circumferential incision along the coronal edge full degloving is performed, and urethral plate is mobilized. Cavernous bodies and neuro-vascular bundles are mobilized. One of the cavernous bodies is detached from the glans. Urethral plate is tubularized until the tip of the glans and deepened below the cavernous bodies. An artificial erection test is performed that shows dorsal curvature. Cavernous bodies are rotated inwards and sutured together to correct curvature. Another artificial erection test is performed which demonstrated a straight penis. Integrity of neuro-vascular bundles is restored, and correct anatomy is reconstructed. Peno-scrotal and peno-pubic junctions are formed. Penile skin is sutured and reconstructed. At the end of the surgery, umbilicoplasty is performed with rectangular skin flap. The results of the surgery were analyzed in both early- and long-term follow-up of up to 3 years. Results: In early and 3-year follow-up, the patient had successful results of the treatment – no recurrent penile curvature was recorded, cosmetic result was close to natural, and no edema was present. Some scarring remained due to the high number of previous surgeries. Conclusions: The improved penile disassembly technique by Perovic allows to get successful both cosmetic and functional results, reconstructing penile anatomy, and decrease the number of post-operative complications preventing recurrence of penile curvature. |
| first_indexed | 2024-04-13T22:52:54Z |
| format | Article |
| id | doaj.art-50c39f1bb81e4e2683c1b7cff7f8ef25 |
| institution | Directory Open Access Journal |
| issn | 2590-0897 |
| language | English |
| last_indexed | 2024-04-13T22:52:54Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj.art-50c39f1bb81e4e2683c1b7cff7f8ef252022-12-22T02:26:06ZengElsevierUrology Video Journal2590-08972022-06-0114100156Penile disassembly technique by Perovic for epispadias repairDina Manasherova0German Kozyrev1Sergei Yatsik2Rados Djinovic3Peoples’ Friendship University of Russia, Miklukho-Maklaya st., 6, Moscow, Russia, 117198; Corresponding author at: Department of Urology & Surgical Nephrology, Peoples’ Friendship University of Russia, 6, Miklukho-Maklaya st, Moscow, Russia, 117198.Peoples’ Friendship University of Russia, Miklukho-Maklaya st., 6, Moscow, Russia, 117198National Medical Research Center for Children's Health Federal State Autonomous Institution of the Russian Federation Ministry of Health, Lomonosovskiy pr., 2-1, Moscow, Russia, 119991Sava Perovic Foundation, Koste Jovanovica, 87, Belgrade, Serbia, 11000Introduction: Bladder exstrophy remains one of the most challenging and complex congenital conditions in pediatric urology. Various techniques have been described to reconstruct penile anatomy, yet a high risk of complications remains [1-5]. There is a limited number of articles dedicated to the use of penile disassembly technique by Perovic.In the presented video, our objective was to demonstrate the improved penile disassembly by Perovic technique. Material and methods: A 23-year-old male patient presented to the clinic after 5 unsuccessful penile surgeries with dorsal penile curvature and meatus located dorsally. With a circumferential incision along the coronal edge full degloving is performed, and urethral plate is mobilized. Cavernous bodies and neuro-vascular bundles are mobilized. One of the cavernous bodies is detached from the glans. Urethral plate is tubularized until the tip of the glans and deepened below the cavernous bodies. An artificial erection test is performed that shows dorsal curvature. Cavernous bodies are rotated inwards and sutured together to correct curvature. Another artificial erection test is performed which demonstrated a straight penis. Integrity of neuro-vascular bundles is restored, and correct anatomy is reconstructed. Peno-scrotal and peno-pubic junctions are formed. Penile skin is sutured and reconstructed. At the end of the surgery, umbilicoplasty is performed with rectangular skin flap. The results of the surgery were analyzed in both early- and long-term follow-up of up to 3 years. Results: In early and 3-year follow-up, the patient had successful results of the treatment – no recurrent penile curvature was recorded, cosmetic result was close to natural, and no edema was present. Some scarring remained due to the high number of previous surgeries. Conclusions: The improved penile disassembly technique by Perovic allows to get successful both cosmetic and functional results, reconstructing penile anatomy, and decrease the number of post-operative complications preventing recurrence of penile curvature.http://www.sciencedirect.com/science/article/pii/S2590089722000330Bladder exstrophyEpispadiasPhalloplastyPenile disassembly |
| spellingShingle | Dina Manasherova German Kozyrev Sergei Yatsik Rados Djinovic Penile disassembly technique by Perovic for epispadias repair Urology Video Journal Bladder exstrophy Epispadias Phalloplasty Penile disassembly |
| title | Penile disassembly technique by Perovic for epispadias repair |
| title_full | Penile disassembly technique by Perovic for epispadias repair |
| title_fullStr | Penile disassembly technique by Perovic for epispadias repair |
| title_full_unstemmed | Penile disassembly technique by Perovic for epispadias repair |
| title_short | Penile disassembly technique by Perovic for epispadias repair |
| title_sort | penile disassembly technique by perovic for epispadias repair |
| topic | Bladder exstrophy Epispadias Phalloplasty Penile disassembly |
| url | http://www.sciencedirect.com/science/article/pii/S2590089722000330 |
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