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Isolated penile torsion in newborns
Egemen Eroglu1, Gokhan Gundogdu1
1Department of Pediatric Surgery, Koc University School of Medicine, Istanbul, Turkey.
Insights
Isolated penile torsion affects 20% of newborns, with significant rotations over 45° in 4.3%. Surgical correction, often degloving and reattachment, is effective for severe cases, with dorsal dartos flap for persistent torsion.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Congenital Anomalies
Background:
- Isolated penile torsion is a congenital anomaly affecting newborn males.
- Understanding its incidence and optimal management is crucial for pediatric urologists.
Purpose of the Study:
- To report the incidence of isolated penile torsion in healthy children.
- To describe the surgical approach and outcomes for penile torsion.
Main Methods:
- Retrospective analysis of newborn babies with penile torsion between 2011 and 2014.
- Classification based on torsion angle and surgical intervention (degloving/reattachment or dorsal dartos flap) for rotations >45°.
Main Results:
- 20% incidence of isolated penile torsion (200/1000 newborns).
- 4.3% (43/1000) had torsions >45°, with 4 >90°.
- Surgical correction in 19 patients (mean age 12 months) showed high success rates, with 2 children having residual rotation <15°.
Conclusions:
- Isolated penile torsion occurs in 20% of newborns, with significant degrees (>45°) in 4.3%.
- Penile degloving with reattachment is sufficient for most cases; dorsal dartos flap is effective for persistent torsion.
- Prior circumcision does not impact surgical outcomes for penile torsion.
Introduction:
We reported on the incidence of isolated penile torsion among our healthy children and our approach to this anomaly.
Methods:
Between 2011 and 2014, newborn babies with penile torsion were classified according to the angle of torsion. Surgical correction (penile degloving and reattachment for moderate cases and dorsal dartos flap technique in case of resistance) after 6 months was advised to the babies with rotations more than 45°.
Results:
Among 1000 newborn babies, 200 isolated penile torsions were found, and among these, 43 had torsions more than 45°, and 4 of these had angles greater than 90°. The mean angle of the rotations was found 30.45° (median: 20°). In total, 8 children with 60° torsions were previously circumcised. Surgery was performed on 19 patients, with a mean patient age of 12 ± 2 months. Of these 19, 13 babies were corrected with degloving and reattachment. This technique was not enough on the remaining 6 patients; therefore, derotational dorsal dartos flap was added to correct the torsion. After a mean of 15.6 ± 9.8 months, residual penile rotation, less than 15°, was found only in 2 children.
Conclusion:
The incidence of isolated penile torsion is 20% in newborns. However, rotation more than 45° angles are seen in 4.3% of male babies. Correction is not necessary in mild degrees, and penile degloving with reattachment is enough in most cases. If the initial correction is insufficient, dorsal dartos flap rotation is easy and effective. Prior circumcision neither disturbs the operative procedure nor affects the outcomes.
