Objective To highlight the clinical presentation, pathological anatomy and surgical management of an emerging condition, the congenital megaprepuce (CM). Patients and methods All patients with CM treated atSouthampton between 1994 and 1998 were reviewed retrospectively; 20 patients underwent surgery (mean age at operation 16 months, range 6±43). Surgical correction developed over this period and variations on a basic technique are now used, depending on the precise pathological anatomy. These techniques are described and illustrated. Cosmetic and functional success, and parental satisfaction, were assessed by a review of the case-notes.Results After a follow-up of o6 months, the cosmetic and functional outcome was very successful, with the parents of 19 of the 20 patients satis®ed. Five patients underwent re-operation, all requiring excision of redundant penile skin. Conclusions CM is a striking condition which cannot be easily missed or hidden; we propose that it is a newly emerging and distinct condition which should not be confused with a buried, concealed, webbed, trapped or micropenis. Early surgical correction is recommended and circumcision should be avoided.

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