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International Urology and Nephrology

, Volume 51, Issue 8, pp 1313–1319 | Cite as

Procedures used for correction of isolated penile torsion: are they competitive or complementary?

  • Hamed M. El DarawanyEmail author
  • Mahmoud E. Al Damhogy
  • Mohamed S. Kandil
  • Mohamed E. ELkordi
  • Salah A. Nagla
  • Mohamed R. Taha
Urology - Original Paper

Abstract

Objectives

To report our experience in starting the correction of penile torsion, whatever its degree (moderate or severe) with one or more simple procedures either separately or complementary in the same session.

Patients and methods

Between 2013 and 2018, 62 patients who have significant isolated penile torsion (> 45°) were involved in this study. Those patients were subjected to either simple degloving with skin reposition, degloving with skin overcorrection and/or dartos flap procedures. Those procedures were performed either separately or complementarily. All patients were examined postoperatively after 7 days and followed up at 3, 6, and 9 months postoperatively.

Results

37 out of 62 patients had a moderate degree (45–90) of penile torsion; 21 of them were corrected using skin degloving–reattachment technique, 11 patients were corrected by degloving with skin overcorrection, and in the remaining 4 patients dartos flap technique was used for correction. In 25/62 patients who had severe degree (> 90°) of torsion; 9 patients were managed by degloving with skin overcorrection, while in 13 patients the procedure was shifted to dartos flap technique, and the remaining 3 patients, 2 of whom had 180° torsion, were managed by dartos flap with added skin overcorrection.

Conclusion

Performing degloving and skin reattachment with or without skin overcorrection procedure and dartos flap procedure either separately or complementarily in the same patient whatever the degree of torsion (moderate or severe) is associated with good results and can protect some patients from exposure to more difficult and extensive procedures as corporopexy and corporeal plication.

Keywords

Penile torsion Degloving Dartos flap Corporopexy 

Notes

Author contributions

HMEl-D and MEAl-D: protocol development, data collection data analysis, manuscript writing. MSK, MEE and SAN: data collection. MRT: manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participant and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. Approval was obtained from the local ethics committee of the Tanta University, Egypt, No. 345/2.

Informed consent

Informed consent was signed by the parents of each patient involved in this study.

References

  1. 1.
    Ben Ari J, Merlob P, Mimouni F, Reisner SH (1985) Characteristics of male genitalia in the newborn. J Urol 134:521–522CrossRefPubMedGoogle Scholar
  2. 2.
    Sarkis PE, Muthurajan S (2007) Incidence and predictive factors of isolated neonatal penile glanular torsion. J Pediatr Urol 3:495–499CrossRefPubMedGoogle Scholar
  3. 3.
    Shaeer O (2008) Torsion of the penis in adults: prevalence and surgical correction. J Sex Med 5:735CrossRefPubMedGoogle Scholar
  4. 4.
    Bar-Yosef Y, Binyamini J, Matzikin H, Ben-Chaim J (2007) Degloving and realignment—simple repair of isolated penile torsion. Urology 69:369–371CrossRefPubMedGoogle Scholar
  5. 5.
    Zhou L, Mei H, Hwang AH, Xie HW, Hardy BE (2006) Penile torsion repair by suturing tunica albuginea to the pubic periosteum. J Ped Surg 41:7–9CrossRefGoogle Scholar
  6. 6.
    Bhat A, Bhat MP, Saxena G (2009) Correction of penile torsion by mobilization of urethral plate and urethra. J Pediatr Urol 5:451–457.  https://doi.org/10.1016/j.jpurol.2009.05.013 CrossRefPubMedGoogle Scholar
  7. 7.
    Azmy A, Eckstein HB (1981) Surgical correction of torsion of the penis. Br J Urol 53:378–379.  https://doi.org/10.1111/j.1464-410X.1981.tb03202.x CrossRefPubMedGoogle Scholar
  8. 8.
    Fisher PC, Park JM (2004) Penile torsion repair using dorsal dartos flap rotation. J Urol 171:1903–1904.  https://doi.org/10.1097/01.ju.0000120148.79867.5c CrossRefPubMedGoogle Scholar
  9. 9.
    Snow Brent W (2009) Penile torsion correction by diagonal corporal plication sutures. Int Braz J Urol 35:56–59.  https://doi.org/10.1590/S1677-55382009000100009 CrossRefPubMedGoogle Scholar
  10. 10.
    Montag S, Palmer LS (2011) Abnormalities of penile curvature: chordee and torsion. Sci World J 11:1470–1478.  https://doi.org/10.1100/tsw.2011.136) CrossRefGoogle Scholar
  11. 11.
    Redman JF, Bissada NK (1967) One stage correction of chordee and 180° penile torsion. Urology 7:632–633CrossRefGoogle Scholar
  12. 12.
    Bhat A, Bhat M, Kumar V, Goyal S, Bhat AK, Patni M (2017) The incidence of isolated penile torsion in North India. J Pediatr Urol 13(491):e1–491.e6Google Scholar
  13. 13.
    Culp OS (1966) Struggles and triumphs with hypospadias and associated anomalies: review of 400 cases. J Urol 96:339CrossRefPubMedGoogle Scholar
  14. 14.
    Abou Zeid AA, Soliman H (2010) Penile torsion: an overlooked anomaly with distal hypospadias. Ann Pediatr Surg 6:93–97Google Scholar
  15. 15.
    Aldaqadossi HA, Elgamal SA, Seif Elnasr M (2012) Dorsal dartos flap rotation versus suturing tunica albuginea to the periosteum for correction of penile torsion: a prospective randomized study. J Pediatr Urol 9:643–647.  https://doi.org/10.1016/j.jpurol.2012.07.014 CrossRefPubMedGoogle Scholar
  16. 16.
    Corriere JN Jr (1981) Involvement of Buck’s fascia in congenital torsion of the penis. J Urol 126:410–411CrossRefPubMedGoogle Scholar
  17. 17.
    Bauer R, Kogan BA (2009) Modern technique for penile torsion repair. J Urol 182:286–291CrossRefPubMedGoogle Scholar
  18. 18.
    Hsieh JT, Wong WY, Chen J, Chang HJ, Liu SP (2002) Congenital isolated penile torsion in adults: untwist with placation. Urology 59:438–440CrossRefPubMedGoogle Scholar
  19. 19.
    Elder JS (2007) Anomalies of the genitalia in boys and their surgical management. In: Wein AJ, Kavoussi LR, Novick AC et al (eds) Campbell-Walsh urology, 9th edn. W. B. Saunders, Philadelphia, pp 3754–3760Google Scholar
  20. 20.
    Zeid AAA, Soliman H (2010) Penile torsion: an overlooked anomaly with distal hypospadias. Ann Pediatr Surg 6(2):93–97Google Scholar
  21. 21.
    Tryfonas GI, Klokkaris A, Sveronis M et al (1995) Torsion of penis: a comparative study between two procedures of skin derotation. Pediatr Surg Int 10:359–361CrossRefGoogle Scholar
  22. 22.
    Eroglu E, Gundogdu G (2015) Isolated penile torsion in newborns. Can Urol Assoc J 9(11–12):E805–E807.  https://doi.org/10.5489/cuaj.2833 (published online 4 Nov 2015) CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Slawin KM, Nagler HM (1992) Treatment of congenital penile curvature with penile torsion: a new twist. J Urol 147:152–154CrossRefPubMedGoogle Scholar
  24. 24.
    Marret JB, Ravasse P, Raffoul L, Rod J (2017) The Fisher technique for correction of penile torsion in children: who are the candidates? Urology 104:179–182CrossRefPubMedGoogle Scholar
  25. 25.
    Elbatarny AM, Ismail KA (2014) Penile torsion repair in children following a ladder step: simpler steps are usually sufficient. J Pediatr Urol 10:1187–1192.  https://doi.org/10.1016/j.jpurol.2014.05.009 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Hamed M. El Darawany
    • 1
    Email author
  • Mahmoud E. Al Damhogy
    • 2
  • Mohamed S. Kandil
    • 2
  • Mohamed E. ELkordi
    • 2
  • Salah A. Nagla
    • 3
  • Mohamed R. Taha
    • 3
  1. 1.Urology Department, Faculty of MedicineKing Fahd Hospital of the University, Imam Abdulrahman Bin Faisal UniversityAlkhobarSaudi Arabia
  2. 2.Tanta Insurance HospitalTantaEgypt
  3. 3.Urology DepartmentTanta UniversityTantaEgypt

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