Penile degloving and dorsal dartos flap rotation approach for the management of isolated penile torsion.

Abstract

Penile torsion is a counterclockwise rotational anomaly of the penile shaft or glans. We aimed to evaluate the outcomes of penile degloving and dorsal dartos flap rotation used for the repair of isolated penil torsion. During evaluation of the patients admitted to our polyclinic for circumcision between January 2013-December 2014, 5 cases of isolated penile torsion were determined. Following the circumcision procedure performed with bipolar cautery, patients undergoing penile degloving were checked whether penile torsion was relieved or not. In case of insufficient improvement, torsion was corrected with application of dorsal dartos flap. Penile torsion was corrected with dartos flap in 2, and penile degloving in 3 cases. The mean age of the patients was 5.6 years (4-7), and the mean operative time 12 minutes (7-20), respectively. The mean operation time was 17.5 (15-20) minutes and 8.3 (7-10) minutes in the dorsal dartos flap and penile degloving groups, respectively. The preoperative mean degree of penile torsion was 50° (30°-70°). The mean degree of torsion was 65° and 40° in the dorsal dartos and penile degloving groups, respectively. During the postoperative follow up, 1 case of residual torsion (<10°) was observed in the dorsal dartos flap group. Residual torsion was not observed in other patients. Exploration for isolated cases of penile torsion during the circumcision procedure should not be overlooked. Successful results can be obtained with penile degloving and dartos flap rotation in cases with low and moderate torsion.