Our Summary

This research paper looks at a condition in adolescents where the penis curves due to a recurrence of an issue that was fixed in childhood. The study reviews the cases of 59 adolescent patients between the ages of 14-21 who had previously undergone surgery to correct this issue, but the curvature had returned. The researchers analyzed the different types of surgeries the patients had initially undergone and the methods used to correct the recurrence.

The researchers found that most of the patients healed well after the secondary surgery, with only two patients having mild recurrence. They also found that a large number of the patients were satisfied with their sexual activity after the surgery and none of the patients who had a specific type of graft reported any issues with sexual function.

The researchers concluded that the curvature can return due to a variety of reasons including tissue and skin scarring around the urethra or uneven growth of the penis. The type of surgical correction depends on how severe the curvature is. They recommend that children who have had this type of surgery should have a follow-up after puberty to monitor for recurrence.

FAQs

  1. What is the condition that causes the penis to curve in adolescents that was mentioned in the study?
  2. How successful was the secondary surgery in correcting the curvature according to the research findings?
  3. What were the researchers’ recommendations for children who have had this type of surgery?

Doctor’s Tip

A doctor might tell a patient undergoing detethering surgery about the importance of following post-operative care instructions, such as keeping the surgical site clean and dry, avoiding strenuous activities, and attending follow-up appointments. They may also advise the patient on the potential risks and complications of the surgery, such as infection or nerve damage, and discuss the expected outcome and recovery time. Additionally, the doctor may recommend physical therapy or other forms of rehabilitation to help improve mobility and function after the surgery.

Suitable For

Detethering surgery is typically recommended for patients who have tethered spinal cord syndrome, which occurs when the spinal cord is abnormally attached to surrounding tissues, causing it to be stretched or pulled. This condition can lead to various neurological symptoms such as weakness, numbness, and loss of bowel or bladder control. Patients with tethered spinal cord syndrome may also experience pain in the lower back, legs, or feet.

Detethering surgery is usually recommended for patients who have symptoms that are affecting their quality of life and are not responding to conservative treatments such as physical therapy or medication. The surgery involves releasing the spinal cord from the surrounding tissues to relieve the tension and pressure on the nerve roots.

Patients who are recommended for detethering surgery may have a variety of underlying conditions that can cause tethered spinal cord syndrome, including spinal cord injury, spinal cord tumors, spinal cord malformations, or previous surgeries in the spinal cord area. The decision to undergo detethering surgery is typically based on the severity of the symptoms, the underlying cause of the tethering, and the potential risks and benefits of the surgery.

Overall, detethering surgery is a safe and effective treatment option for patients with tethered spinal cord syndrome, and can help improve symptoms and quality of life. Patients who are considering detethering surgery should consult with a neurosurgeon or spinal cord specialist to discuss their individual case and determine the best course of treatment.

Timeline

Before detethering surgery:

  • Patient may experience symptoms such as urinary retention, incontinence, constipation, leg weakness, and back pain
  • Patient may undergo diagnostic tests such as MRI or ultrasound to confirm the presence of a tethered spinal cord
  • Patient may undergo physical therapy or other conservative treatments to manage symptoms
  • If symptoms persist or worsen, patient may be recommended for detethering surgery

After detethering surgery:

  • Patient undergoes surgery to release the tethered spinal cord
  • Patient may experience pain, discomfort, and swelling at the surgical site post-operatively
  • Patient may need to stay in the hospital for a few days for monitoring and recovery
  • Patient may require physical therapy or rehabilitation to regain strength and mobility
  • Patient may experience improvement in symptoms such as urinary retention, incontinence, and leg weakness
  • Patient may need to follow-up with their surgeon for monitoring and follow-up care to ensure proper healing and recovery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with detethering surgery?
  2. How long is the recovery time after detethering surgery?
  3. What type of anesthesia will be used during the surgery?
  4. Will I need to stay in the hospital overnight after the surgery?
  5. What is the success rate of detethering surgery in preventing the recurrence of penile curvature?
  6. Will I need to undergo any additional procedures or treatments after the surgery?
  7. How soon after surgery can I resume normal sexual activity?
  8. Are there any long-term effects or implications of detethering surgery that I should be aware of?
  9. What post-operative care will be required after the surgery?
  10. Are there any alternative treatments or therapies that could be considered instead of detethering surgery?

Reference

Authors: Abosena W, Talab SS, Hanna MK. Journal: J Pediatr Urol. 2020 Apr;16(2):162.e1-162.e5. doi: 10.1016/j.jpurol.2019.11.013. Epub 2019 Dec 2. PMID: 31974021