Buried penis; what buried the penis?

Area of Science:

• Urology
• Pediatric Surgery
• Histopathology

Background:

• Buried penis (BP) is a congenital condition requiring surgical correction.
• Understanding the histological characteristics of the dartos fascia is crucial for effective surgical management.
• Dartos fascia plays a role in penile development and support.

Purpose of the Study:

• To compare the histological and immuno-histochemical features of dartos fascia in children with buried penis (BP), hypospadias, and normal anatomy.
• To identify specific dartos fascia abnormalities associated with BP.
• To provide insights for surgical correction of BP.

Main Methods:

• Histological examination of dartos fascia specimens from 40 children (13 BP, 14 hypospadias, 13 controls).
• Assessment of collagen, elastin, nerve fibers, tactile bodies, fat, and smooth muscle content.
• Blind examination by a single pathologist.

Main Results:

• Dartos fascia in BP exhibited significantly thicker collagen fibers, thicker smooth muscle fibers, and thicker convoluted nerve fibers compared to controls and hypospadias groups.
• The hypospadias group showed predominant intermediate collagen fibers and distinct elastin fiber patterns.
• Hypospadias group also displayed disorganized, nonparallel smooth muscle fibers.

Conclusions:

• The dartos fascia in buried penis is characterized by abnormal thickening of collagen, smooth muscle, and nerve fibers.
• These histological findings may contribute to the inward retraction observed in BP.
• Excision of this abnormal dartos fascia is likely recommended during surgical correction for buried penis.