Efficacy and anthropometric predictors of negative-pressure therapy for recurrent concealed penis in pediatric...

The present study aimed to evaluate the clinical efficacy, safety, and three-month durability of negative-pressure therapy (NPT) as a non-surgical salvage intervention for pediatric patients with postoperative recurrent concealed penis.

This retrospective longitudinal observational study reviewed 126 pediatric patients who completed a standardized 20-session, pressure-titrated negative-pressure protocol between September 2022 and June 2025 for postoperative recurrence. Primary outcomes included changes in visible penile length (VPL), flaccid penile length (FPL), stretched penile length (SPL), and penile diameter. Morphometric parameters were recorded at baseline, immediately post-treatment, and at a prespecified three-month follow-up.

Significant morphometric gains were achieved across all dimensions (all P < 0.001). VPL increased by a mean of 0.76 cm (95% CI: 0.68 to 0.84), demonstrating a substantial clinical effect (Cohen's dz = 1.64). Anatomical gains in FPL, SPL, and diameter were similarly robust and successfully maintained at 3 months, with no significant regression (P > 0.05). Multivariable analysis revealed that advanced chronological age (P = 0.005), higher body mass index (P = 0.037), and smaller baseline dimensions (P < 0.01) were independent predictors of superior anatomical improvement. The protocol was well tolerated with no serious adverse events.

NPT represents an effective, non-invasive salvage strategy for pediatric recurrent concealed penis. By leveraging mechanotransduction to overcome fibrotic restriction, this modality provides stable anatomical expansion and serves as a viable alternative to complex re-operation, particularly for older children with higher adiposity and more severe initial concealment.