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Circumcising Incision: Surgical Approach to the Penile Shaft
Urologic Indications for a Circumcising Incision
Circumcising incision is done for a surgical approach to the penile shaft:
- Peyronie disease
- Penile fracture
- Surgical approach to the penile urethra
Preoperative Patient Preparations
- Patient positioning: supine position
- General or spinal anesthesia
- Perioperative antibiotic prophylaxis
Surgical Technique of a Circumcising Incision
- Circumferential incision along the coronal sulcus. In circumcised patients, the incision is done along the circumcision scar.
- The skin of the penile shaft is pulled back and mobilized (degloving) on the level of the Buck fascia.
- In uncircumcised patients, the inner layer of the prepuce is resected analogous to a circumcision.
- Paramedian splitting of Buck fascia at 3 and 9 o'clock to isolate the neurovascular bundle. The neurovascular bundle is mobilized directly on the level of the tunica albuginea. A vessel loop is used for handling of the mobilized neurovascular bundle.
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References
Deutsche Version: Zirkumzidierender Operationszugang zum Penisschaft