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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.

References

  Deutsche Version: Zirkumzidierender Operationszugang zum Penisschaft