Clinical application of penile fascia anatomy in the surgery of congenital concealed penis

doi:10.13418/j.issn.1001-165x.2024.6.01

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Chinese Journal of Clinical Anatomy ›› 2024, Vol. 42 ›› Issue (6) : 617-621. DOI: 10.13418/j.issn.1001-165x.2024.6.01

Clinical application of penile fascia anatomy in the surgery of congenital concealed penis

Zhang Hongyi¹, Feng Gaifeng², Zhou Haibin¹, Sun Menghang¹, Wang Chenyue¹, Li Huafeng¹, Cui Jie³*, Jin Lei³*

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Abstract

Objective To explore the etiology of congenital concealed penis and provide theoretical basis for preventing postoperative penile retraction, long-term lymphedema of prepuce by the anatomical observation of penile fasciae in cadavers. Methods Ten adult male cadaver penises were dissected to observe the structures of penile fasciae. The anatomical findings were applied to the surgery for correcting congenital concealed penis. The intraoperative and postoperative data of 60 patients were investigated and recorded. Results The dartos fascia has sub-layers. Many blood vessels, nerves, and lymphatic tissues were found in the superficial layer. The reserve of an intact superficial layer of dartos fascia during surgery will help prevent long-term lymphedema of prepuce. The deep layer of dartos fascia was a membranous tissue with fewer venules, and there were many fused fibers with the superficial layer of dartos fascia or Buck's fascia. The deep layer of dartos fascia was fixed to Buck's fascia by the fused fibers. After removing the deep layer of dartos fascia, the penis was extended obviously. None of the patients underwent postoperative penile retraction. The Buck's fascia fixed the dorsal artery, deep dorsal vein and dorsal nerves to tunica albuginea. The injury may lead to severe complications. The skin borderline between penile shaft and mons pubis or scrotum, as well as the fat plane of subpubic or scrotal septum, is an anatomical landmark for reconstructing the penoscrotal angle. Conclusions The anatomical structures and functions of penile fascia are different. It is important to have a good understanding of the anatomical structure to prevent the penis retraction after operation, long-term lymphedema of prepuce and restore the normal appearance of the penis.

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Concealed penis / / / Fascia / / / Applied anatomy / / / Sub layer

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Zhang Hongyi, Feng Gaifeng, Zhou Haibin, Sun Menghang, Wang Chenyue, Li Huafeng, Cui Jie, Jin Lei. Clinical application of penile fascia anatomy in the surgery of congenital concealed penis[J]. Chinese Journal of Clinical Anatomy. 2024, 42(6): 617-621 https://doi.org/10.13418/j.issn.1001-165x.2024.6.01

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