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Congenital megaprepuce: an emerging condition--how to recognize and treat it
D J Summerton1, J McNally, A J Denny
1Department of Paediatric Urology, Southampton General Hospital, UK.
Objective:
To highlight the clinical presentation, pathological anatomy and surgical management of an emerging condition, the congenital megaprepuce (CM).
Patients And Methods:
All patients with CM treated at Southampton between 1994 and 1998 were reviewed retrospectively; 20 patients underwent surgery (mean age at operation 16 months, range 6-43). Surgical correction developed over this period and variations on a basic technique are now used, depending on the precise pathological anatomy. These techniques are described and illustrated. Cosmetic and functional success, and parental satisfaction, were assessed by a review of the case-notes.
Results:
After a follow-up of >/= 6 months, the cosmetic and functional outcome was very successful, with the parents of 19 of the 20 patients satisfied. Five patients underwent re-operation, all requiring excision of redundant penile skin.
Conclusions:
CM is a striking condition which cannot be easily missed or hidden; we propose that it is a newly emerging and distinct condition which should not be confused with a buried, concealed, webbed, trapped or micropenis. Early surgical correction is recommended and circumcision should be avoided.