Dorsal dartos flap for buried penis treatment: surgical technique and long-term outcomes

The objective of our study was to report our long-term experience in buried penis (BP) treatment based on dorsal dartos flap technique. Several surgical techniques have been proposed, yielding differing long-term outcomes; however, no single approach is currently recognized as the gold standard.

We performed a observational retrospective study on patients under 18 years with BP treated at our institution between 2014 and 2019. A coronal incision was performed, degloving the penis and creating a dorsal dartos flap that was later divided in the midline, forming two lateral flaps which were fixed with interrupted stiches on each side of the penis base. Demographic variables, surgical duration, and postoperative complications were evaluated. Cosmetic outcomes were assessed through a survey conducted with the patients' parents.

A total of 19 patients were included, with a mean age of 7.5 years (interquartile range 4.3-9.7). Mean surgery time was 43.8 ± 5.5 min. All patients were discharged within 24 h of surgery. No postoperative complications or reoperations occurred, with a median follow-up period of 96 months (interquartile range 82-108 months). Regarding the cosmetic outcomes, 95% of patients parents were satisfied with the outcome of the procedure, 89% considered optimal the age at which surgery was performed, 100% considered it a minimally invasive procedure, and 95% would recommend it.

Surgical correction of BP using dorsal dartos flap is a simple and a promising surgical alternative, associated with negligible morbidity and satisfactory cosmetic and functional long-term outcomes. Therefore, it should consider it as an alternative treatment for BP.