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Concealed epispadias associated with a buried penis
Ricardo Sol Melgar1, Daniela Gorduza1, Delphine Demède1
1Department of Paediatric Urology, Hôpital Mère-Enfant, Université Claude-Bernard, Bron, France.
Insights
This study highlights that buried penis and epispadias can coexist in children. Early detection and simultaneous surgical correction are recommended for these congenital penile anomalies.
Area of Science:
- Pediatric Urology
- Congenital Genitourinary Abnormalities
Background:
- Buried penis is a congenital defect involving the penile shaft skin and an unretractable foreskin.
- Epispadias is a congenital anomaly of the urethra and glans.
- These anomalies are typically isolated but can be associated.
Observation:
- A retrospective review identified five children with both buried penis and epispadias.
- Three children presented with glanular epispadias, and two had midshaft epispadias.
- Surgical management involved the Cantwell-Ransley procedure combined with penile skin refashioning.
Findings:
- Four out of five patients achieved satisfactory outcomes post-surgery.
- One patient required additional urethroplasty due to glanular dehiscence.
- The study confirms the possibility of co-occurrence of these penile anomalies.
Implications:
- Parents of children with buried penises should be informed about the potential for associated epispadias.
- Palpation for a dorsal cleft in the glans through the foreskin may indicate an underlying epispadiac urethra.
- Simultaneous surgical correction of both buried penis and epispadias is feasible and effective.
Objective:
The aim was to describe the clinical presentation and the surgical management of penile epispadias associated with a buried penis in five children.
Patients And Methods:
This is a 5-year retrospective review of patients presenting with a buried penis, a congenital defect of the penile skin shaft associated with an unretractable foreskin for whom a penile epispadias was found at the time of surgery. All had undergone surgery combining a Cantwell-Ransley procedure and refashioning of the penile skin following the authors' technique.
Results:
Three children had a glanular epispadias and two had a midshaft epispadias. Four had a satisfactory outcome, and one required a complementary urethroplasty for glanular dehiscence.
Conclusion:
Buried penis and epispadias are usually isolated congenital anomalies, although they can be associated. It is therefore recommended to warn parents about the possibility of underlying penile anomaly in children with buried penises and unretractable foreskin. Careful palpation of the dorsum of the glans through the foreskin looking for a dorsal cleft could indicate an associated epispadiac urethra. Surgical correction of both anomalies can be done at the same time. Parents of boys with buried penises should be warned that underlying penile anomaly may exist.