ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

CONCLUSIONS

Early colostomy was performed in both cases due to imperforate anus. Urinary tract reconstruction

is individually tailored, while the cosmetic and functional repair of the perineum represents a major

challenge.

16:13–16:15

S3-12 (CP)

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COMPLETE PENILE GLANS NECROSIS:

GLANULOPLASTY WITH OCCLUSIVE DRESSINGS

AND BUCCAL MUCOSA RESURFACING

Luca MAZZONE and Daniel Max WEBER

University Children’s Hospital Zurich, Division of Pediatric Urology, Department of Pediatric Surgery, Zurich,

SWITZERLAND

PURPOSE

Glans ischemia is an uncommon complication after circumcision. Several reports describe suc-

cessful management using agents that promote revascularization, typically by the mean of va-

sodilatation. Here we present a case with complete glans necrosis that required its amputation and

reconstruction.

MATERIAL AND METHODS

An eight-year old patient presented with mummification of the glans, urinary retention and super-

infection two weeks after having undergone circumcision abroad. Initial treatment consisted of iv

antibiotics and insertion of a suprapubic catheter. The entire necrotic glans was debrided, the short

shaft skin was pexed to the shaft and the urethra to the corpus spongiosum at the level of the

coronal sulcus. The urethra was stented with a Zaontz catheter to allow an occlusive hydrocolloid

dressing of the exposed corpora cavernosa. Dressing changes occurred weekly under anesthesia.

After 4 weeks, a buccal mucosa transplant was used to cover the well-shaped “neo-glans” com-

posed of granulation tissue.

RESULTS

Occlusive hydrocolloid wound dressings over four weeks allowed the formation of glans-shaped

granulation tissue. Grafting with a free mucosa transplant was successful and led to a scar-free

resurfacing of the “neo-glans”. The neo-meatus, located at the level of the coronal sulcus, remained

wide and permitted normal bladder voiding.

CONCLUSIONS

Glanuloplasty with occlusive dressings and buccal mucosa resurfacing may result in satisfactory

cosmesis in prepubertal boys.