HASAN YILMAZ, Murat ÜSTÜNER, Mustafa YÜKSEKKAYA, Mehmet Esat KÖSEM, Ali Kemal USLUBAŞ, Mustafa Melih ÇULHA

Erişkin gömük penis rekonstrüksiyonunda yeni suprapubik insizyon tekniği

AMAÇ: Çalışmamızda, erişkin gömük penis hastalarında suprapubik lipektomi sonrası penisin daha uzun ve estetik görünmesi için uyguladığımız suprapubik insizyon tekniğini değerlendirmeyi amaçladık.GEREÇ VE YÖNTEM: Kliniğimizde 2013-2016 yılları arasında, suprapubik yağlanma nedeniyle fonksiyonel penis boyunun kısaldığını düşünen 19 hastanın verileri geriye dönük değerlendirildi. Penopubik bileşkenin yaklaşık 2 cm üstünden ters hilal şeklinde 8 cm'lik transvers cilt insizyonu yapıldıktan sonra, penis kökü, rektus fasyası ve cilt arasındaki tüm adipoz dokular eksize edildi (suprapubik lipektomi). Ardından, insizyonun lateral uçları subdermislerinden orta hatta rektus fasyasına 2/0 emilebilir poliglaktin sütürler ile sabitlendi. Böylece transvers insizyon vertikal plana getirilmiş oldu. Vertikal planda alt ve üst uçta oluşan cilt kulakçıkları açık üçgen şeklinde eksize edilerek, insizyonun estetik görünümün sağlanması amaçlandı. Daha sonra insizyon kapatıldı. Suprapubik lipektomi ile elde edilen penis uzunluğunun korunması ve tamamlanması amacıyla ventralde penoskrotal bileşkeye "Z plasti" uygulandı.BULGULAR: Ortanca hasta yaşı 31 (20-67) idi. Hastaların kilolarına göre beş hasta normal kiloda, dokuz hasta aşırı kilolu, beş hasta ise obez iken, hiçbir hasta morbid obez değildi. Ortanca vücut kitle indeksi (VKİ) ise 24,7 (21,8-34,2) kg/m2 idi. Ortalama cerrahi süresi 65±25 dk idi. Ortanca penis boyu uzaması 2,3(1,3-3,6) cm idi (p

A new suprapubic incision technique for reconstruction of the adult buried penis

OBJECTIVE: We present a novel suprapubic incision technique to obtain amore esthetical and longer penis appearance in adult patients with complaining buried penis.MATERIAL AND METHODS: We retrospectively evaluated medical records of 19 patients who underwent reconstruction of adult buried penis in our clinic between 2013 and 2016. All procedures began with a 8 cm transvers downward crescent incision 2 cm above the penoscrotal junction. After removing all adipose tissue among skin, rectus fascia, and penile root (suprapubic lipectomy), the lateral tips of the incision are fixed in the midline from their subdermis to rectus fascia. Thus, the transvers incision is broughtto vertical plan. The tips of the new vertical incision are extracted like an open triangle to obtain a more esthetical wound suturation. After suturation, a ventral “Z plasty” incision is applied to penoscrotal junction to prevent the dorsal growing penile length.RESULTS: The median patient age was 31 (20–67). As regarding the weight of the patients, five had normal weight, nine patients were over weight, five patients were obese. None of the patients had morbide obesity. The median body mass index was 24.7 (21.8–34.2) kg/m2. The mean operation time was 65±25 min. The median increase in penile length was 2.3(1.3–3.6) cm (p

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