mnowitzke
New
PREOPERATIVE DIAGNOSIS: Chordee with mild hypospadias.
POSTOPERATIVE DIAGNOSIS: Chordee with mild hypospadias.
PROCEDURE PERFORMED: Correction of chordee with circumcision.
SURGEON: M.D.
ANESTHESIA: General.
INDICATIONS FOR PROCEDURE: This is a 2-year-old boy who was born with
chordee with penile torsion to the right side and mild hypospadias. It
was decided that his hypospadias did not need to be repaired.
DESCRIPTION OF PROCEDURE: Following satisfactory induction of general
anesthesia, the abdomen and genitalia were prepped with Betadine
solution. He was draped in the usual manner. The penile adhesions were
lysed and the penis was re-prepped with Betadine solution. A 5-0
Prolene traction stitch was placed through the dorsum of the glans penis. A
circumferential incision was made 1 cm proximal to the coronal sulcus.
The penis was degloved at the level of Buck's fascia laterally and
dorsally, whereas ventrally, the skin was dropped back at the level of
the dermis. The urethra appeared to be relatively well vascularized.
When the penis was completely degloved, hemostasis was achieved.
Next, a dorsal incision was made in the foreskin to the midportion of
the penis. The foreskin flaps were transferred ventrally on each side
of the penis. The Byars flaps were transferred and the penile skin was
distributed evenly around the penis. A 5-0 fast absorbing gut was
placed between the vertex of the dorsal penile skin incision and the
mucosal skin distally. At this point, the penile shaft appeared
straight with no torsion or ventral curvature. A midline incision was
made in the ventral penile skin and a midline ventral skin closure was
preformed with interrupted 5-0 fast absorbing gut after redundant
foreskin was excised. The penile skin was sutured to the distal mucosal
skin with interrupted running 5-0 fast absorbing gut.
Next, at the request of the anesthesiologist, a penile nerve block was
performed with 0.25% Marcaine.
Xeroform gauze was applied and the patient was brought out of general
anesthesia.
POSTOPERATIVE DIAGNOSIS: Chordee with mild hypospadias.
PROCEDURE PERFORMED: Correction of chordee with circumcision.
SURGEON: M.D.
ANESTHESIA: General.
INDICATIONS FOR PROCEDURE: This is a 2-year-old boy who was born with
chordee with penile torsion to the right side and mild hypospadias. It
was decided that his hypospadias did not need to be repaired.
DESCRIPTION OF PROCEDURE: Following satisfactory induction of general
anesthesia, the abdomen and genitalia were prepped with Betadine
solution. He was draped in the usual manner. The penile adhesions were
lysed and the penis was re-prepped with Betadine solution. A 5-0
Prolene traction stitch was placed through the dorsum of the glans penis. A
circumferential incision was made 1 cm proximal to the coronal sulcus.
The penis was degloved at the level of Buck's fascia laterally and
dorsally, whereas ventrally, the skin was dropped back at the level of
the dermis. The urethra appeared to be relatively well vascularized.
When the penis was completely degloved, hemostasis was achieved.
Next, a dorsal incision was made in the foreskin to the midportion of
the penis. The foreskin flaps were transferred ventrally on each side
of the penis. The Byars flaps were transferred and the penile skin was
distributed evenly around the penis. A 5-0 fast absorbing gut was
placed between the vertex of the dorsal penile skin incision and the
mucosal skin distally. At this point, the penile shaft appeared
straight with no torsion or ventral curvature. A midline incision was
made in the ventral penile skin and a midline ventral skin closure was
preformed with interrupted 5-0 fast absorbing gut after redundant
foreskin was excised. The penile skin was sutured to the distal mucosal
skin with interrupted running 5-0 fast absorbing gut.
Next, at the request of the anesthesiologist, a penile nerve block was
performed with 0.25% Marcaine.
Xeroform gauze was applied and the patient was brought out of general
anesthesia.
