[Modified Brisson surgery combined with skin flap clipping for the treatment of severe concealed penis in children].

OBJECTIVE: To explore the effect of modified Brisson surgery combined with the skin flap clipping technique in the treatment of severe concealed penis in children.
METHODS: We retrospectively analyzed the clinical data on 165 children with severely concealed penis treated in our hospital from January 2014 to January 2019, 105 by modified Brisson surgery combined with the skin flap clipping technique and the other 60 by modified Devine surgery, all the operations performed by the same surgeon. We compared the two surgical strategies concerning operation time, intraoperative blood loss, postoperative increase of penile exposure, preputial edema duration, flap necrosis and penile retraction, and satisfaction of the patients' parents with the overall surgical effect.
RESULTS: No injury of the dorsal nerve or urethra, nor postoperative refractory prepuce edema or painful erection was found in any of the cases. The patients treated by modified Brisson surgery, in comparison with those treated by modified Devine surgery, showed significantly less intraoperative blood loss (［8.4 ± 1.60］ vs ［12.6 ± 2.10］ ml, P < 0.05), more postoperative increase of penile exposure (［2.7 ± 0.29］ vs ［2.3 ± 0.22］ cm, P < 0.05), fewer cases of flap necrosis (1 vs 4, P < 0.05) and higher rate of satisfaction with the overall surgical effect (94.9% vs 84.5%, P < 0.05), but there were no statistically significant differences between the former and the latter groups in the operation time (［48.3 ± 4.1］ vs ［48.1 ± 5.0］ min, P > 0.05) or the postoperative duration of prepuce edema (［3.3 ± 0.93］ vs ［3.2 ± 0.90］ d, P > 0.05) or number of cases of penile retraction at 6 months (1 vs 1, P > 0.05).
CONCLUSIONS: Modified Brisson surgery combined with the skin flap clipping technique can achieve satisfactory results in the treatment of severe concealed penis in children and therefore deserves to be popularized in clinical application.