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Concealed index for concealed penis in prepubertal children
Kobiljon Ergashev1, Jae Min Chung1,2,3, Sang Don Lee1,2,4
1Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Insights
New concealed penis (CP) indices objectively measure severity and surgical outcomes. These concealed indices (CIs) and concealed indices according to circumference (CIc) provide valuable diagnostic and evaluative tools for CP repair.
Area of Science:
- Urology
- Pediatric Surgery
- Medical Engineering
Background:
- Concealed penis (CP) is a genital anomaly requiring surgical correction.
- Objective metrics are needed to assess CP severity and surgical success.
Purpose of the Study:
- To develop an objective severity index for concealed penis (CP).
- To compare penile parameters of CP with normal penis (NP) and evaluate postoperative outcomes.
Main Methods:
- Retrospective study of 391 boys (<14 years), including 105 with CP.
- Measured stretched penile length (SPL), penile circumference (PC), and baseline skin level length (BPL).
- Defined concealed index (CIs) as BPL/SPL and concealed index by circumference (CIc) as BPL/PC.
Main Results:
- CP group showed significantly shorter SPL, BPL, and lower CIs and CIc compared to NP.
- Established cutoff values: CIs 0.68 and CIc 0.58 for diagnosis.
- Postoperative CP repair significantly improved all measured penile parameters.
Conclusions:
- Concealed indices (CIs) and (CIc) are effective, objective tools for assessing CP severity.
- Newly introduced cutoff values aid in diagnosing CP and evaluating repair outcomes.
- These indices enhance the objective assessment of concealed penis and its surgical management.
Purpose:
The concealed penis (CP) is a congenital or acquired genital anomaly that requires surgical correction. To construct an objective CP severity index, we compared the penile parameters of a CP with a normal penis (NP) and postoperative outcomes of CP patients.
Materials And Methods:
In this retrospective study, 391 boys under 14 years who visited our hospital between September 2017 and February 2020 were included. Among these boys, 105 patients had a CP and 286 boys had a NP without CP. The stretched penile length (SPL), penile circumference (PC), and penile length above baseline skin level (BPL) were measured using a ruler (cm), and the testicular volume was measured using an orchidometer (mL). We defined the concealed index according to SPL (CIs) as BPL/SPL and the concealed index according to circumference (CIc) as BPL/PC. A repair of the CP was performed in the CP patients. All parameters were measured before surgery and after three months.
Results:
The CP had significantly shorter SPL and BPL, and smaller CIs, and CIc than the NP. The cutoff values for the CIs and CIc were 0.68 and 0.58, respectively (sensitivity 86.7% and 86.7%; specificity 65.0% and 88.5%, respectively). After repair of the CP, all penile parameters were significantly improved.
Conclusions:
The CIs and CIc are useful and objective parameters for checking the severity of CP, and evaluating the postoperative outcome of CP repair. We newly introduced cutoff values for the CIs (0.68) and CIc (0.58) for diagnosing and evaluating CP repair.
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