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Eur J Pediatr Surg 2014; 24(02): 158-162
DOI: 10.1055/s-0033-1343083
Original Article
Georg Thieme Verlag KG Stuttgart · New York

A Novel Technique of Concealed Penis Repair

Jung Jun Kim
1   Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
,
Dong-Gi Lee
2   Department of Urology, Kyung Hee University School of Medicine, Seoul, Republic of Korea
,
Kwan Hyun Park
3   Department of Urology, Seoul Samsung Urology Clinic/Gynecology Health Care Center, Ulsan, Republic of Korea
,
Minki Baek
1   Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

03 January 2013

04 February 2013

Publication Date:
15 April 2013 (online)

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Abstract

Introduction The correction of concealed penis requires challenging surgical techniques. We describe a novel technique involving inner preputial skin substitution after degloving through a ventral approach that allows sufficient penile skin coverage and evaluated the efficacy and safety of our technique.

Methods From February 2009 to March 2009, 12 boys with concealed penises underwent correction via our novel technique. We administered a questionnaire about penile size, morphology, and voiding status to parents to evaluate their satisfaction with the results.

Results The mean age of patients at the time of operation was 4.71 ± 4.01 years, and the mean duration of follow-up was 5.11 ± 1.45 months. Parental satisfaction grades (0 to 4) concerning penile size increased from 1.00 ± 1.04 to 2.83 ± 0.94 (p = 0.002) after surgery, penile morphology from 1.00 ± 0.95 to 3.00 ± 0.85 (p = 0.001), and voiding status from 1.08 ± 1.00 to 3.33 ± 0.78 (p < 0.001) at the last follow-up visit. The parental satisfaction rates regarding postoperative changes in size and morphology were 83.3 and 91.7%, respectively. Nine parents (75%) said they would recommend the surgery to others. There were no complications, including postoperative hematoma, infection, and tissue necrosis.

Conclusion Our method of correcting concealed penis was demonstrated to be technically feasible and safe. It provides a good cosmetic appearance and excellent parental satisfaction ratings regarding size, morphology, and voiding function.

Keywords

penis - urogenital abnormalities - reconstructive surgical procedures
 

  • References

  • 1 Maizels M, Zaontz M, Donovan J, Bushnick PN, Firlit CF. Surgical correction of the buried penis: description of a classification system and a technique to correct the disorder. J Urol 1986; 136 (1 Pt 2) 268-271
    PubMedGoogle Scholar
  • 2 Johnston JH. Other penile abnormalities. In: Williams DI, Hohenfellner R, Eckstein HB, , eds. Surgical Pediatric Urology. Stuttgart: Thieme; 1977: 406-413
    Google Scholar
  • 3 Srinivasan AK, Palmer LS, Palmer JS. Inconspicuous penis. ScientificWorldJournal 2011; 11: 2559-2564
    CrossrefPubMedGoogle Scholar
  • 4 Lee T, Suh HJ, Han JU. Correcting congenital concealed penis: new pediatric surgical technique. Urology 2005; 65 (4) 789-792
    CrossrefPubMedGoogle Scholar
  • 5 Wollin M, Duffy PG, Malone PS, Ransley PG. Buried penis. A novel approach. Br J Urol 1990; 65 (1) 97-100
    CrossrefPubMedGoogle Scholar
  • 6 Herndon CD, Casale AJ, Cain MP, Rink RC. Long-term outcome of the surgical treatment of concealed penis. J Urol 2003; 170 (4 Pt 2) 1695-1697 , discussion 1697
    CrossrefPubMedGoogle Scholar
  • 7 Donahoe PK, Keating MA. Preputial unfurling to correct the buried penis. J Pediatr Surg 1986; 21 (12) 1055-1057
    CrossrefPubMedGoogle Scholar
  • 8 Radhakrishnan J, Razzaq A, Manickam K. Concealed penis. Pediatr Surg Int 2002; 18 (8) 668-672
    PubMedGoogle Scholar
  • 9 Gillett MD, Rathbun SR, Husmann DA, Clay RP, Kramer SA. Split-thickness skin graft for the management of concealed penis. J Urol 2005; 173 (2) 579-582
    CrossrefPubMedGoogle Scholar
  • 10 Kojima Y, Hayashi Y, Maruyama T , et al. Correction of completely buried penis using the modified preputial island pedicle flap method. J Pediatr Surg 1999; 34 (10) 1524-1526
    CrossrefPubMedGoogle Scholar
  • 11 Smeulders N, Wilcox DT, Cuckow PM. The buried penis—an anatomical approach. BJU Int 2000; 86 (4) 523-526
    CrossrefPubMedGoogle Scholar
  • 12 Brisson P, Patel H, Chan M, Feins N. Penoplasty for buried penis in children: report of 50 cases. J Pediatr Surg 2001; 36 (3) 421-425
    CrossrefPubMedGoogle Scholar
  • 13 Frenkl TL, Agarwal S, Caldamone AA. Results of a simplified technique for buried penis repair. J Urol 2004; 171 (2 Pt 1) 826-828
    CrossrefPubMedGoogle Scholar
  • 14 Borsellino A, Spagnoli A, Vallasciani S, Martini L, Ferro F. Surgical approach to concealed penis: technical refinements and outcome. Urology 2007; 69 (6) 1195-1198
    CrossrefPubMedGoogle Scholar
  • 15 Sugita Y, Ueoka K, Tagkagi S, Hisamatsu E, Yoshino K, Tanikaze S. A new technique of concealed penis repair. J Urol 2009; 182 (4, Suppl): 1751-1754
    CrossrefPubMedGoogle Scholar
  • 16 Boemers TM, De Jong TP. The surgical correction of buried penis: a new technique. J Urol 1995; 154 (2 Pt 1) 550-552
    CrossrefPubMedGoogle Scholar
  • 17 Chu CC, Chen YH, Diau GY, Loh IW, Chen KC. Preputial flaps to correct buried penis. Pediatr Surg Int 2007; 23 (11) 1119-1121
    CrossrefPubMedGoogle Scholar
  • 18 Hägglöf B, Andrén O, Bergström E, Marklund L, Wendelius M. Self-esteem in children with nocturnal enuresis and urinary incontinence: improvement of self-esteem after treatment. Eur Urol 1998; 33 (Suppl. 03) 16-19
    PubMedGoogle Scholar
  • 19 Shenoy MU, Srinivasan J, Sully L, Rance CH. Buried penis: surgical correction using liposuction and realignment of skin. BJU Int 2000; 86 (4) 527-530
    CrossrefPubMedGoogle Scholar