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Modifications of preputial unfurling to reduce postoperative edema in buried penis
Taiwai Chin1, Hsinlin Tsai, Chinsu Liu
1Division of Pediatric Surgery, Children's Medical Center, Veterans General Hospital-Taipei, 201, Shih Pai Road, National Yangming University, Taipei, Taiwan 11217, R.O.C. twchin@vghtpe.gov.tw
Objective:
Buried penis is a result of penile skin deficiency and inadequate attachment of the skin to the Buck's fascia. Prolonged postoperative edema (>1 month) has been seen in some patients after preputial unfurling. Some modifications which may reduce this complication are described.
Patients And Methods:
Thirty-two boys with buried penis, aged 14 months to 12 years, underwent the surgical procedure. A circumferential incision was made at the junction of the outer and inner prepuce. The subcutaneous tissue was removed from the inner prepuce and degloved from the Buck's fascia, so that a thin inner prepuce could be sutured directly to Buck's fascia. Excessive prepuce was trimmed. Reapproximation of the outer and the inner prepuce completed the procedure. A narrow skin ring at the penile base, which may compromise venous and lymphatic flow, was avoided by dorsal or ventral incision.
Results:
Mild edema was seen in some patients but subsided within a month. Satisfactory cosmetic results were achieved.
Conclusions:
This procedure unfurls the inner prepuce to cover the penile shaft. Ideal cosmetic results can be achieved if some details of the procedure are emphasized.
