Anterior scrotum of the penis

　　1. Etiology

　　The etiology of anterior scrotum of the penis is unknown. It may be due to some reason causing the delay in the development process of the genital结节 forming the penis, while the labioscrotal隆突 continues to grow and develop in front of it. It may also be that in the case of simultaneous development of the genital结节 and labioscrotal隆突, the labioscrotal隆突 fails to migrate downward to the penis, causing the interposition of the penis and scrotum.

　　2. Pathogenesis

　　The scrotum of patients with anterior scrotum of the penis is in a split shape, located in the anterior superior part of the penis. It is divided into complete anterior scrotum of the penis and partial anterior scrotum of the penis according to the degree of displacement of the scrotum and penis. The former refers to the complete displacement of the scrotum above the penis, while the latter refers to the scrotum only partially located above the penis. Without hypospadias, the penis develops normally without penile curvature and urethral opening displacement.

　　This disease belongs to a congenital chromosomal abnormality, and its incidence in clinical practice is very rare. The complications are mainly due to developmental abnormalities causing infertility and sterility, accompanied by other abnormal development of tissues and organs, such as the absence of testicles, eunuchism, abnormal shape of the clitoris, urethral畸形, etc. For patients with urethral畸形, urinary system infection may occur due to abnormal urination.

　　In complete prepuce of the penis, the penis is completely located behind the scrotum or between the scrotum and anus, and the penis itself develops normally. In partial prepuce of the penis, the penis is often located in the middle and posterior part of the scrotum, which is often accompanied by hypospadias, penile curvature, short penis, anal atresia, and other malformations.

　　This disease belongs to a chromosomal disease, and the etiology of the chromosomal malformation is unclear. It may be related to environmental factors, genetic factors, dietary factors, and emotional and nutritional factors during pregnancy, so the disease cannot be prevented directly. During pregnancy, regular checks should be done, and if the child shows a tendency of developmental abnormality, chromosomal screening should be done in time, and if confirmed, an induced abortion should be performed in time to avoid the birth of children with the disease.

　　Routine karyotype analysis and sex chromosome analysis are performed to exclude chromosomal abnormalities.
　　According to the typical clinical manifestations of the scrotum located above the penis, the diagnosis can be made clear. It should be noted whether there is a congenital abnormality such as hypospadias, and at the same time, it should be distinguished from hypospadias of the split scrotum type.

　　1. Strengthen physical exercise, enhance physical fitness, reduce risk factors such as smoking and alcoholism, and improve one's own immunity.

　　2. Pay attention to the protection of the perineum in daily life to prevent injuries, in order to prevent kicks and scratches during play and fighting.

　　3. Eat more foods rich in vitamin C, such as fresh vegetables and fruits. In daily life, adhere to eating low-fat foods, such as lean meat and low-fat dairy products.

　　4. It is advisable to eat light, eat more vegetables and fruits, rationally match the diet, pay attention to adequate nutrition, avoid smoking and drinking, avoid spicy and pungent foods. Avoid greasy foods, smoking and drinking. Avoid eating cold and raw foods.

　　The prepuce of the penis does not affect sexual life and treatment is only to solve the abnormal appearance. For those with less serious partial prepuce of the penis, treatment may not be necessary. The surgery is to make an 'M' type incision along the superior edge of the scrotum wings and the junction of the penis and scrotum, and turn the scrotum under the penis. For cases with severe hypospadias, the above method is used after completing the urethral shaping surgery. To protect the blood supply of the prepuce flap, it is often advocated to repair the prepuce of the penis after 6 months postoperatively.