Elsevier

Urology

Volume 88, February 2016, Pages 166-169
Urology

Pediatric Urology
New Technique for the Treatment of Buried Penis in Children

https://doi.org/10.1016/j.urology.2015.09.031Get rights and content

Objective

To present our treatment experience of buried penis, which has no consensus therapeutic technique for all cases of buried penis, by using a new technique for the repair of this condition, in which the approach is through the ventral penile root.

Materials and Methods

We performed a retrospective review of 153 patients (median age: 6.5 years) who underwent repair of a buried penis between March 2005 and March 2013. The technique involves the creation of a wedge-shaped cut of the ventral penile skin, followed by fixation of the subcutaneous penile skin at the base of the degloved penis to the Buck fascia at the 2- and 10-o'clock positions. The ventral outer preputial skin is split down the midline, and the dorsal inner preputial skin is cut with oblique incision.

Results

All patients were followed for an average of 12 months after repair. Other than 2 cases (1.3%) of trapped penis with a ring of scar tissue, which required subsequent excision, there were no complications and the cosmetic appearance was satisfactory.

Conclusion

The described ventral penile approach is a simple and effective procedure with good cosmetic outcomes and few complications.

Section snippets

Patients

Patients who underwent surgical correction of the buried penis at our institution from March 2005 to March 2013 were reviewed retrospectively. Inclusion criteria were patients undergoing their first surgical correction for a normal-sized, short-appearing penis that was completely buried in the prepubic tissue. Patients were excluded if they had concomitant genital anomalies, including concealed penis, webbed penis, trapped penis, or clubbed penis. The parents of the children consented to the

Results

A retrospective review of the hospital records identified 153 males who met the inclusion criteria for the study. Patients ranged in age from 3 to 14 years (median age: 6.5 years). The mean lengths of the exposed penile shaft before and after the operation were 2.35 ± 0.62 cm and 4.23 ± 0.48 cm, respectively (P < .05). No serious complications developed during the average 12-month follow-up period, and all patients had a cosmetically pleasing result. Two patients (1.3%) developed a trapped

Discussion

Owing to its diverse spectra of severity, controversy exists concerning the causes and treatment of buried penis.8 We agree with the etiology proposed by Smeulders et al,6 which states that migratory failure of the tissue planes during penile development leads to formation of extensive adhesions between the penile corpora and Buck fascia. The surgical technique used in the present case series combines previously described methods, such as complete shaft degloving, release of anomalous dartos

Conclusion

We found a favorable short-term success rate for patients with buried penis, especially when the ventral penile skin was comparatively redundant. We believe that our technique is a useful procedure for treatment of buried penis. As most of our patients were prepubertal, long-term follow-up and multicenter experiences with this approach are indicated before this technique can be generally recommended.

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Financial Disclosure: The authors declare that they have no relevant financial interests.

Authors' Contributions: Feng Liu: manuscript writing and project development; Tao Lin: project development; Dawei He: project development; Guanghui Wei: protocol; Junhong Liu: project development; Xing Liu: data management; Yi Hua: data management; Deying Zhang: data management; Peng Lu: data analysis; Shengde Wu: data analysis; Xuliang Li: manuscript editing and protocol/project development.

Ethical Standard: All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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