Painful erection correction

Painful penile erection correction is used for the treatment of hypospadias. Hypospadias is a congenital malformation more common in pediatric genitourinary system. At the 5th week of the embryo, the tissues on both sides of the front of the cloaca are forwarded, producing two reproductive nodules. The reproductive nodules grow rapidly, and the urogenital sinus elongates, forming a longitudinal line on the ventral side of the reproductive nodules. The long groove, the urethral groove, closes from the posterior to the uterus as the fetus develops. In the development process, there are obstacles, and the urethral groove can not be completely closed to the tip of the penis head, which causes partial cracking and formation of hypospadias. Curing disease: Indication All types of congenital hypospadias should be treated with hypospadias. Preoperative preparation 1. On the 1st day before surgery, the skin of the field is disinfected with 1:500 benzalkonium solution or 75% ethanol. The urethra was infused with 1:2000 benzalkonium solution 2 to 3 ml to disinfect the urethra. 2, preparation of blood 200 ~ 400ml. 3. Apply antibiotics. 4. Clean the enema. Surgical procedure 1. Loosen the penis in the penis head and sew a needle and double thread for the operation of the penis during and after surgery. Make a circular incision along the coronal sulcus and make a parallel incision in the ventral side of the penis until the urethral orifice is next to the urethral orifice, and make a "V" shaped incision above the urethral opening, which is 0 and 3 cm away from the urethral orifice. 2. Remove the skin between the parallel incisions and remove all the fiber cords between the coronal sulcus and the urethral opening with a sharp knife or scissors until the grooves between the white membranes of the two corpus cavernosums are completely exposed. At the time of separation, the cord or sheet-like fibrous tissue is separated from the penis fascia and the penis white membrane by a mosquito forceps upward and toward the midline. 3. After cutting the fiber band to cut the fiber band, the anterior segment of the penis is released, and then continues to the direction of the urethral opening. The fiber cable strip extends to the sides at this site, and the fascia is separated and collapsed on both sides of the urethral opening. The penis fascia is cut open to release the penis, and the distal urethra is released 1 to 2 cm to loosen the corpus cavernosum which is retracted to the proximal side of the urethral opening. If the urethral stricture is combined or the urethral end lacks the cavernous tissue, the external urethra should be cut longitudinally to facilitate the formation of stage II urethra. In the process of separation, penile wounds often appear to ooze blood, generally do not need to be ligated to stop bleeding, only use gauze compression for a while to stop bleeding. The cut white film or larger bleeding spots can be sewn with silk. The flaky hemorrhage can be treated by electrocoagulation with argon electrocautery. The urethral sponge at the outer urethra can be sutured on the tunica albuginea to stop bleeding. 4, suture flaps according to the specific circumstances transfer the foreskin, penis or scrotal flap to cover the wound. (1) Metastasis method: If the foreskin is too much on the dorsal side, the incision of the coronal groove is extended to cut the foreskin in a ring shape, and when the dorsal side is free, the dorsal vessels and nerves of the penis on the surface of the white membrane must be avoided. Spread the foreskin and do a midline incision to form the left and right foreskin flaps. The foreskin flap was moved to the ventral side of the penis to cover the wound surface. The skin wound edge was sutured with a 1-0 silk thread. The needle stitches near the urethral opening should pass through the white membrane to eliminate the dead space. Using this method, the wound scar is relatively neat. (2) Staggered flap method: When the penis skin is not enough, especially in the case of scrotal or perineal hypospadias, after correcting the penis, the penis and scrotal flaps are made according to the specific conditions. Or 3 lateral incisions, forming 2 or 3 triangular flaps, and then suturing the flaps (Figures 12, 23, 3, 3-4D-F). (3) transfer scrotal flap method: perineal hypospadias disease, if the penis skin is insufficient, you can borrow scrotal skin. Make a transverse incision on the distal side of the urethral opening, and extend the ends of the incision to the scrotum skin on both sides of the penis to form a rectangular flap. When the penis is corrected, the scrotal flaps are sutured in the midline to cover the penile wound. 5. Indwell the catheter and fix it with a silk thread. Wrap the penis with several layers of gauze, apply a little pressure, and secure the dressing with sutures. complication 1, bleeding After the urethral sponge or the penis leucorrhea is cut, if the suture is not sutured, hemorrhage may occur when the penis is erected. When the compression is used, the wound must be opened to remove the hematoma and suture to stop bleeding. 2, infection Especially on the basis of bleeding and hematoma, infection is more likely to occur. 3, necrosis When the tension of the suture is too large, it may cause cracking and partial necrosis. Therefore, if the tension is too large after suturing, the dorsal incision should be made.