Miko24
Guru
PROCEDURES PERFORMED: Buried penis repair, cystoscopy
FINDINGS:
. Penis due to cicatrix located at the distal penile shaft
Hypospadiac meatus with 2 false dimples, but the true meatus was patent and accommodated a 17 French scope
Will proceed with lateral slits to cut through the cicatrix and closed in a Heineke-Mikulicz fashion to allow for exposure of the head of the penis.
PROCEDURE DETAILS:
Patient was prepped in the standard sterile fashion. Significant compression of the surrounding suprapubic fat pad was performed to allow for exposure of the head of the penis. A penile traction stitch was placed. Betadine was used to clean underneath the foreskin and the head of the penis. Incisions were made through the cicatrix at the 3 and 9:00 positions with a scalpel this released the scar tissue and allowed for the penile shaft skin to freely move over top of the head of the penis. Which was the operative goal. The longitudinal 3 and 9:00 incisions were then closed in a horizontal fashion with interrupted 2-0 Vicryl's. This was performed after hemostasis was achieved with electrocautery. A flexible cystoscope was then used to perform cystoscopy. The patient did have hypospadias with the true meatus located at the level of the coronal sulcus. There were 2 false dimples located further distal on the urethral plate. Flexible cystoscope inspected the urethra and the bladder there was no concerning bladder tumor stones or lesions and no urethral stricture. Nothing to account for the microscopic hematuria. The cystoscope was then removed. We attempted to place a dressing on the penis but as soon as the patient flexed a little bit waking up the penis pulled back and a dressing fell off.
FINDINGS:
. Penis due to cicatrix located at the distal penile shaft
Hypospadiac meatus with 2 false dimples, but the true meatus was patent and accommodated a 17 French scope
Will proceed with lateral slits to cut through the cicatrix and closed in a Heineke-Mikulicz fashion to allow for exposure of the head of the penis.
PROCEDURE DETAILS:
Patient was prepped in the standard sterile fashion. Significant compression of the surrounding suprapubic fat pad was performed to allow for exposure of the head of the penis. A penile traction stitch was placed. Betadine was used to clean underneath the foreskin and the head of the penis. Incisions were made through the cicatrix at the 3 and 9:00 positions with a scalpel this released the scar tissue and allowed for the penile shaft skin to freely move over top of the head of the penis. Which was the operative goal. The longitudinal 3 and 9:00 incisions were then closed in a horizontal fashion with interrupted 2-0 Vicryl's. This was performed after hemostasis was achieved with electrocautery. A flexible cystoscope was then used to perform cystoscopy. The patient did have hypospadias with the true meatus located at the level of the coronal sulcus. There were 2 false dimples located further distal on the urethral plate. Flexible cystoscope inspected the urethra and the bladder there was no concerning bladder tumor stones or lesions and no urethral stricture. Nothing to account for the microscopic hematuria. The cystoscope was then removed. We attempted to place a dressing on the penis but as soon as the patient flexed a little bit waking up the penis pulled back and a dressing fell off.