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Foreskin preservation in penile surgery
Warren T Snodgrass1, Martin A Koyle, Laurence S Baskin
1University of Texas Southwestern Medical Center at Dallas, USA.
The Journal of Urology
|July 4, 2006
Summary
Foreskin reconstruction during penile surgery, including hypospadias repair, is safe and effective. This technique preserves the foreskin, offering a viable option for parents desiring an uncircumcised appearance post-surgery.
Area of Science:
- Urology
- Pediatric Surgery
- Plastic Surgery
Background:
- Most penile surgeries in the US result in circumcision.
- Parental/patient preference for an uncircumcised appearance is sometimes a consideration.
- Foreskin reconstruction offers an alternative to complete foreskin removal.
Purpose of the Study:
- To evaluate the safety and efficacy of foreskin reconstruction during penile surgery.
- To assess outcomes in patients undergoing hypospadias repair with foreskin reconstruction.
- To report collective experience from multiple institutions.
Main Methods:
- A retrospective review of 58 patients undergoing penile surgery with foreskin reconstruction over 6 years.
- Procedures included hypospadias repair, chordee correction, and dorsal hood reconstruction.
- Foreskin reconstruction involved multilayered reapproximation of the dorsal hood margins.
Main Results:
- 56 of 58 patients achieved retractable foreskin post-reconstruction.
- Complications included foreskin dehiscence in 2 patients and a urethral fistula in 1.
- Three patients requested secondary circumcision for cosmetic reasons or personal preference.
Conclusions:
- Foreskin reconstruction is a safe procedure with a low complication rate in selected patients.
- Higher risk cases involve proximal hypospadias or extensive penile degloving.
- Phimosis resulting from reconstruction can often be managed with topical steroids.