METHOD FOR MEASURING REMOVED FORESKIN SIZE IN PHIMOSIS AND INSTRUMENT FOR IMPLEMENTING THEREOF

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to urology, andrology and paediatric surgery, and aims at measuring a foreskin resection extent in surgical management of phimosis. Synechias are separated. An used instrument for measuring the removed foreskin size in phimosis comprises a U-shaped spring-assisted flat elastic plate with two parallel branches of equal length and asymmetric in the centre of a wedge portion, a rounded face of radius 4.5 mm. One of the branches has a ruler with a millimetre scale on the outside. Another branch is wedge-shaped and passes smoothly into a rod with a rounded probe end. Its wedge portion comprises symmetrical grooves from both sides to hold the instrument properly and measure the removed foreskin size. The rounded end of the rod of the instrument is inserted to a bottom of a preputial cavity and around the foreskin circumferentially not less than in four fixed points of a sagittal plane. The instrument is turned around 90° sideways with continuing to compress the branches and knurling horizontally with a scalpel along the cutout surfaces of the probe branch on the outside of the cavity along a resection line of the preset foreskin portion. Then, with keeping the instrument in use, a grooved probe is inserted into the formed holes and dissecting alongside the foreskin leaves in combination with hemostasis. An incision formed by joining the cuts together is sutured at once with a blanket absorbable suture. The instrument stretches the foreskin cavity thereby avoiding incision narrowing. The last knot of the suture is used as a holder. The grooved probe is delivered once more from an incision place through the following incision thereby joining all measured points of the foreskin removal together. A longitudinal strip of skin is cut out in a segment of frenulum of prepuce for the purpose of preserving and lengthening frenulum of penis. The instrument is removed, and additional interrupted sutures are used to form the frenulum. As a health supplement, a solution of lidocaine and aqueous chlorhexidine are used.;EFFECT: method allows to measure the removed foreskin size precisely by means of the used instrument.;4 cl, 3 ex, 8 dwg