| ObjectiveTo explore the correlation between different body mass index(BMI),pre-pubic symphysis fat thickness(h)and the efficacy of concealed penile surgery.MethodsA retrospective analysis of the clinical data of children with concealed penis who underwent surgical treatment at Hunan Provincial People’s Hospital from January 1,2019 to August 30,2020,a total of 144 study subjects were collected,and the patients were divided into normal groups of 52 cases based on BMI,43 cases of overweight group,49 cases of obesity group,all patients were treated by the same doctor with modified Devine operation.Before the operation,the thickness of the fat before the symphysis pubis(h)was measured by B-ultrasound,and the length of the penis before the operation(d1)was measured by a ruler.The length of the penis immediately afterwards(d2).The average follow-up was 6-9 months,and the follow-up length of the penis was measured(d3),and then the postoperative penile retraction length(d4=d2-d3)and postoperative penis length increase(Δd=d3-d1)were calculated.One-way analysis of variance,Spearman rank correlation analysis,Chi-square test,and multivariate binary logistic regression analysis were used to study the correlation between BMI,pre-pubic fat thickness and the efficacy of concealed penile surgery,and K-means clustering and decision tree methods were used to explore The guiding value of BMI and fat thickness before symphysis pubis to the timing of concealed penis surgery.Results1.Spearman rank correlation analysis of 144 study subjects showed that age was related to preoperative penis length(d1),immediate postoperative penis length(d2),postoperative follow-up penis length(d3),postoperative penile retraction length(d4)The postoperative penis length increase(Δd)is positively correlated.Height is positively correlated with d2,d3,d4,andΔd.Body weight is positively correlated with d2 and d4.BMI is negatively correlated with d1,d3,andΔd,and positively correlated with d4.The thickness of pre-pubic symphysis fat(h)is negatively correlated with d1,d3,andΔd,and positively correlated with d4.2.Among the 144 patients in this study,123 cases were effective in surgical treatment,and the overall effective rate was 85.42%.In 52 cases of normal body reconstitution,50 cases were effective in surgical treatment,and the effective rate was 96.15%;43 cases were overweight,38 cases were effective in surgical treatment,and the effective rate was 88.37%;49 cases in the obesity group,35 cases were effective in surgical treatment,and the effective rate was 71.43%.There was no significant difference in the effective rate between the normal group and the overweight surgery(P>0.05).There was a significant difference between the obesity group and the normal group and the overweight surgery(P<0.05),showing that the normal group and the overweight patients had better surgical results Obesity group.3.One-way analysis of variance showed significant differences in postoperative penile length increase(F=21.764,P<0.001)and postoperative penis retraction length(F=25.802,P<0.001)in different BMI groups,and then multiple comparisons were made between the groups.The analysis results showed that the postoperative penile retraction length of the obese group was greater than normal group and overweight group.4.Multivariate logistic regression analysis showed that BMI is a risk factor affecting the postoperative efficacy of concealed penis patients,and height is a protective factor affecting the postoperative efficacy of concealed penis patients.5.Through the K-means clustering method,the critical range of the best curative effect in this study is postoperative penis length increase(Δd)>2.02cm and postoperative penis retraction length(d4)<0.63cm.Then,the decision tree classification is performed to obtain the best curative effect BMI and the critical range of pre-pubic symphysis fat thickness(h),that is,h≤6.5mm,BMI≤16.15 kg/m~2.ConclusionIn concealed penis patients,BMI and the thickness of pre-pubic symphysis fat(h)were negatively correlated with preoperative penis length and postoperative penis length increase,and positively correlated with postoperative penile retraction length.The greater the thickness of pre-pubic symphysis fat and BMI,the more serious the degree of penis concealment,the smaller the increase in length of the penis after surgery,and the greater the length of penis retraction after surgery.This study found that when h≤6.5mm and BMI≤16.15 kg/m~2,the patient has the best surgical effect.Therefore,this study believes that preoperative assessment of patients’BMI and pre-pubic symphysis fat thickness has important clinical value,and may have a guiding role in the timing of surgery for patients with concealed penis. |
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