Therapeutic effects of modified Devine surgery for concealed penis in children

Considerable controversy exists regarding the surgical indications for a concealed penis. We herein describe a modified technique for correction of a concealed penis. The superfluous inner plate is resected to accelerate the disappearance of the postoperative lymphedema, and the skin between the penis and scrotum is trimmed to recover the penoscrotal angle.

From January 2014 to October 2017, 79 patients with a concealed penis underwent our modified Devine penoplasty procedure. We measured the penile length preoperatively and postoperatively to confirm the improvement. A questionnaire was administered to the patients' parents to assess satisfaction regarding penile size, morphology, voiding status, and hygiene.

The perpendicular penile length was 1.88 ± 0.76 cm preoperatively and 4.42 ± 0.48 cm postoperatively, representing a significant improvement(p < 0.05). The parents' satisfaction grades for penile size, morphology, voiding status, and hygiene were significantly improved postoperatively (p < 0.05). Almost every patient had postoperative penile lymphedema; however, this symptom had spontaneously resolved by 6 weeks. No other complications occurred, such as skin necrosis, tissue contracture, or wound infection.

The herein-described modified repair technique for a concealed penis was technically feasible and safe, and excellent postoperative satisfaction was achieved. Additionally, the postoperative penis exhibited a good cosmetic appearance. Because of the successful outcomes with few complications, we believe that this surgical method for selected patients with a concealed penis is more effective than the traditional method.

Level IV, therapeutic study.