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Penoplasty for buried penis in children: report of 50 cases
1Department of Pediatric Surgery, Floating Hospital for Children, Boston, MA, USA.
Insights
This study details a surgical technique for buried penis in children, achieving excellent cosmetic results and low complication rates. The procedure offers significant psychological benefits for patients and parents, with early intervention recommended.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Buried penis is a common congenital condition in children.
- Surgical intervention is often necessary for functional and cosmetic correction.
Purpose of the Study:
- To describe a novel surgical technique for treating buried penis in pediatric patients.
- To evaluate the efficacy and safety of this technique in a large cohort.
Main Methods:
- Retrospective chart review of 50 consecutive pediatric buried penis cases (1993-1999).
- Surgical repair utilizing a technique that avoids circumferential incision and employs vertical mattress sutures.
- Patient ages ranged from 11 months to 13 years at the time of surgery.
Main Results:
- All 50 patients achieved good to excellent outcomes with minimal complications.
- A 6% rate of recurrent retraction required additional procedures.
- Patients experienced mild, transient postoperative edema and discomfort, with improved penile shaft visualization.
Conclusions:
- Surgical correction of buried penis is generally warranted, offering psychological benefits.
- The described technique provides excellent cosmetic results and a low complication rate.
- Early surgical intervention (as early as 3 months) is safe and effective; routine circumcision in infants with buried penis is not recommended.
Purpose:
The authors report their experience with a large number of children with buried penis and describe their surgical technique.
Methods:
Fifty consecutive cases of buried penis that occurred between 1993 and 1999 were analyzed by chart review. Age at the time of surgery was 11 months to 13 years. Each patient underwent elective surgical repair utilizing a surgical technique not described previously. The authors' technique avoids a circumferential incision at the base of the penis, decreasing postoperative edema. The authors also utilize a unique through and through vertical mattress suture at the base of the penis that firmly attaches the shaft skin to the underlying corpora.
Results:
All patients had a good to excellent outcome with a low postoperative complication rate. One patient fell during the postoperative period and developed a wound dehiscence. Early in the series 3 patients underwent additional procedures for recurrent retraction (6%). All patients experienced some postoperative discomfort as expected. Edema, when present, was mild and resolved within an acceptable period of time. All patients had a good cosmetic result with increased visualization of the penile shaft.
Conclusions:
A surgical approach to the buried penis is warranted in most circumstances. There are psychological benefits to both the patients and the parents. Although the authors perform the procedure as early as 11 months, it can be performed safely at 3 months. The procedure reported here provides immediate excellent cosmetic results with a low complication rate. The authors do not recommend suprapubic lipectomy either alone or in combination with the buried penis procedure. Circumcision should be avoided in an infant with a definite diagnosis of buried penis.
