DOuble LOngitudinal Megapreputium Incision TEchnique: the DOLOMITE

Area of Science:

• Pediatric Urology
• Plastic Surgery
• Surgical Techniques

Background:

• Congenital megaprepuce presents a unique surgical challenge.
• Existing techniques may not optimally preserve penile skin.
• A need exists for straightforward, reproducible surgical solutions.

Purpose of the Study:

• To introduce and detail the DOuble LOngitudinal Megapreputium Incision TEchnique (D.O.L.M.I.T.E.).
• To demonstrate the principle of preserving outer penile shaft skin for dorsal coverage.
• To present a step-by-step surgical approach for congenital megaprepuce.

Main Methods:

• The D.O.L.M.I.T.E. technique involves two longitudinal incisions (ventral and dorsal).
• Penile skin is hinged dorsally, with redundant inner preputial tissue resected via diagonal incisions.
• Dartos tissue is preserved throughout the procedure.

Main Results:

• Six pediatric patients (mean age 13.3 months) underwent the procedure.
• Excellent cosmetic outcomes were achieved post-operatively.
• Scars became inconspicuous, and voiding normalized with no complications.

Conclusions:

• The D.O.L.M.I.T.E. technique is a straightforward and reproducible surgical correction for congenital megaprepuce.
• The method ensures optimal preservation and utilization of penile shaft skin.
• The technique demonstrates a favorable safety and efficacy profile.