I. Introduction of the disease: penile sclerosis is a fibrotic lesion of the white membrane of the penile corpus cavernosum, causing single or several patches or hard nodules to appear on the dorsal or lateral side of the penis. There is no specific medicine for this disease, and drug treatment is generally anti-fibrotic, with a long course of disease and poor treatment effect. When the erectile deformity of the penis is obvious, surgery can be considered to remove the sclerotic node, and the defect needs to be covered by transplanting skin tendon membrane, sheath or oral mucosa. Basic information: Patient Xiao Liu, male, 52 years old, general worker, junior high school education, usually does not smoke or drink, and has good living habits. Medical history: Xiao Liu found by chance a hard lump on the left side of the root of his penis 3 years ago when taking a bath, about the size of a grain of rice, not painful or itchy, and able to have a normal erection. There is no pain during erection, so he did not pay attention to it at that time and did not seek medical attention. In the past year, it is obvious that the hard lump has gradually increased in size and is now the size of a soybean, and when the penis is erect, it is found to be skewed to the left side. Fourth, the specialist examination: penis development is normal, the left side of the penis root can be touched about 1.0 × 37.5px hard nodes, clear boundary, hard texture, mild tenderness. The right side of the penis was normal. V. Preliminary diagnosis: penile sclerosis. VI. Post-admission examination: ① penile blood flow Doppler ② penile cavernosography ③ all blood laboratory indexes are normal; VII. Analysis of results: ① penile blood flow Doppler can help us understand the blood supply of Xiao Liu’s penis as a routine assessment before surgery. The principle of this test is to use ultrasound to detect the arteries and veins of the penis under the condition of erection. The referenced normal values are as follows: 1. Arterial systolic maximum flow rate PSV (the main index to assess the blood supply of penile arteries):When PSV<625px/s, it indicates that the blood supply of penile arteries is insufficient. 2. Diastolic flow rate EDV (an important index to assess the function of penile vein closure):When EDV>125px/s, it indicates that the penile vein closure mechanism is incomplete and the penis cannot be erected normally. 3, resistance index RI: the average value of RI in normal people is 0.99, the average value of RI in simple arterial insufficiency is 0.96, and the average value of RI in simple venous insufficiency is 0.71, which is significantly lower than normal. The mean value of RI for both abnormalities is even lower at 0.63, while the examination results of Liu are PSV=1180px/s, EDV=0/s, RI:1 on the right side and PSV=860px/s, EDV=0/s, RI:1 on the left side, taking into account the blood flow of Liu’s penis on both sides, we believe that Liu’s penile blood flow is completely normal and there is no contraindication for surgery. . In addition, the ultrasound additionally observed that the local tissue thickening of the left cavernous body of Xiao Liu’s penis was about 4.75px, with a range of about 67.5pxX35px, uniform internal echogenicity, and no blood flow signal was seen, which, combined with the physical examination, provided us with a reference basis for roughly judging the scope of surgical excision. ② Penile cavernosography can help us understand the overall shape of the cavernous body of Xiao Liu’s penis under erection, which is helpful for us to clarify whether Xiao Liu also has the symptoms of penile distortion due to the coexistence of the penis itself. The test is performed by puncturing both sides of the penile corpus cavernosum with an erect penis and injecting contrast quickly, followed by continuous and rapid radiographs. From the cavernous body imaging results of Xiao Liu, it was obvious that when Xiao Liu’s penis was erect, it was bent to the left side and the overall shape of the penile cavernous body was intact. From this, we can basically exclude the skewing of the penis due to other causes besides hard nodes. VIII. Final diagnosis: left penile cavernous sclerosis IX. Treatment: After basic preoperative preparation, we performed left penile sclerotomy + oral mucosal penile leukodystrophy under general anesthesia. The defect area after sclerotomy was large, and we chose to cover the defect with oral mucosa graft from Xiao Liu (the wound recovered very quickly after oral mucosa excision). The tissue excised during the surgery was sent to the pathology department for laboratory examination. ▲Note: The pathology results suggest that the sclerotic nodes are benign tissue. After returning to the ward after the surgery, we gave Xiao Liu symptomatic treatment such as anti-infection and hemostasis. The patient was discharged from the hospital on the third day after surgery with the joint efforts of our medical and nursing staff. After discharge, he came to our clinic for review 1 week later according to the medical advice. X. Review record: 2016.1.13 Q: Doctor, I am now half a month after surgery, the wound has basically healed, occasionally erection, erection is straight, but the local will still be some pain, can be slightly tolerated. I have not been having intercourse with my wife yet. So I want to ask, in my case, about how long can I have intercourse? A: (after careful examination of the penis) I have seen your wound, the basic growth, but now can not have intercourse, because the inside of the stitches still need time to grow, at least a month, now intercourse is prone to things. Go back to recuperate, if there is no discomfort, next time do not come to the follow-up.