“…Follow-up of the studied patients in the current study revealed that most of the studied patients developed post-operative penile edema and only one patient developed skin infection; these complications did not vary significantly among the studied groups and responded well and rapidly to conservative treatment. This observation was similar to the findings of Kassem et al [ 1 ] in their study who concluded that early treatment of buried penis by phallopexy is safe and associated with minor post-operative complications which were also improved rapidly by conservative measures.…”
Section: Discussionsupporting
confidence: 92%
“…1 ). This condition is usually associated with poor cosmoses, difficult accessibility resulting in poor hygiene, social embarrassment, recurrent balanitis, difficult urination, and secondary phimosis [ 1 , 2 ]. Fig.…”
Background
Comparison between three different surgical techniques in the management of concealed penis.
Methods
This prospective interventional non-randomized study included 150 pediatric patients with a concealed penis. They were distributed equally into three groups; group A; patients treated by anchoring the penile skin dermis to Buck's fascia at the penile base at 3 and 9 o'clock points using PDS 5/0 (phallopexy), group B; patients treated by complete dissection and excision of dartos fascia and group C; patients treated by phallopexy as in group A after complete dissection and excision of dartos fascia. Follow-up at the end of the 1st post-operative week and then monthly for 6 months as regards penile skin congestion and/or necrosis, wound infection, edema, and/or re-retraction was carried out.
Results
Penile edema and re-retraction have a statistically significant difference among the studied groups (p < 0.001 and p = 0.002 respectively). Penile re-retraction was noticed to be lowest in patients of group C, however penile edema was observed to be highest in patients of group B.
Conclusions
Phallopexy after complete dissection and excision of dartos fascia have better results than doing either phallopexy or dartos excision alone in the treatment of concealed penis.
Clinical trial registration: The manuscript was registered in ClinicalTrials.gov Protocol Registration and Results System. ClinicalTrials.gov Identifier: NCT05565040. Our manuscript was registered on 4/10/2022.
“…Follow-up of the studied patients in the current study revealed that most of the studied patients developed post-operative penile edema and only one patient developed skin infection; these complications did not vary significantly among the studied groups and responded well and rapidly to conservative treatment. This observation was similar to the findings of Kassem et al [ 1 ] in their study who concluded that early treatment of buried penis by phallopexy is safe and associated with minor post-operative complications which were also improved rapidly by conservative measures.…”
Section: Discussionsupporting
confidence: 92%
“…1 ). This condition is usually associated with poor cosmoses, difficult accessibility resulting in poor hygiene, social embarrassment, recurrent balanitis, difficult urination, and secondary phimosis [ 1 , 2 ]. Fig.…”
Background
Comparison between three different surgical techniques in the management of concealed penis.
Methods
This prospective interventional non-randomized study included 150 pediatric patients with a concealed penis. They were distributed equally into three groups; group A; patients treated by anchoring the penile skin dermis to Buck's fascia at the penile base at 3 and 9 o'clock points using PDS 5/0 (phallopexy), group B; patients treated by complete dissection and excision of dartos fascia and group C; patients treated by phallopexy as in group A after complete dissection and excision of dartos fascia. Follow-up at the end of the 1st post-operative week and then monthly for 6 months as regards penile skin congestion and/or necrosis, wound infection, edema, and/or re-retraction was carried out.
Results
Penile edema and re-retraction have a statistically significant difference among the studied groups (p < 0.001 and p = 0.002 respectively). Penile re-retraction was noticed to be lowest in patients of group C, however penile edema was observed to be highest in patients of group B.
Conclusions
Phallopexy after complete dissection and excision of dartos fascia have better results than doing either phallopexy or dartos excision alone in the treatment of concealed penis.
Clinical trial registration: The manuscript was registered in ClinicalTrials.gov Protocol Registration and Results System. ClinicalTrials.gov Identifier: NCT05565040. Our manuscript was registered on 4/10/2022.
“…al. (1) in their study who concluded that early treatment of buried penis by phallopexy is safe and associated with minor postoperative complications which were also improved rapidly by conservative measures.…”
Section: Discussionmentioning
confidence: 99%
“…1) This condition is usually associated with poor cosmoses, di cult accessibility resulting in poor hygiene, social embarrassment, recurrent balanitis, di cult urination, and secondary phimosis. (1,2) The pathogenesis of this anomaly was attributed to an excessive development of the penile dartos fascia retracting the penis inwards, an insu cient attachment of the penile skin to the deep penile tissues at the penile base, and/or tight phimosis which is often present. Also, excessive pre-pubic fat is usually present and worsens the appearance of the abnormality but does not explain the pathology by itself.…”
Background: Comparison between three different surgical techniques in the management of concealed penis.
Methods: This prospective interventional non-randomized study included 150 pediatric patients with concealed penis. They were distributed equally into three groups; group A; patients treated by anchoring the penile skin dermis to Buck's fascia at the penile base at 3 & 9 o'clock points using PDS 5/0 (phallopexy), group B; patients treated by complete dissection and excision of dartos fascia & group C; patients treated by phallopexy as in group A after complete dissection and excision of dartos fascia. Follow-up at the end of the 1st post-operative week and then monthly for 6 months as regards penile skin congestion and/or necrosis, wound infection, edema, and/or re-retraction was carried out.
Results: Penile edema and re-retraction have a statistically significant difference among the studied groups (p< 0.001& p= 0.002 respectively). Penile re-retraction was lowest in patients of group C and penile edema was lowest in patients of group B.
Conclusions: Phallopexy after complete dissection and excision of dartos fascia have better results than doing either phallopexy or dartos excision alone in the treatment of concealed penis
“…[ 1 ] Abnormal dartos muscle is thought to be the basic defect in congenital mega prepuce. [ 2 ] The penile skin is loosely attached to the shaft at penoscrotal and penopubic angles. It is also characterised by typical ballooning [ Figure 1 ] of the prepuce during micturition.…”
Introduction:
Early management of congenital megaprepuce (CMP) is necessary to address recurrent urinary tract infections and parental concerns. Different procedures, mostly using the inner preputial skin to cover the phallus, have been described. However, cosmetic appearance with the inner preputial covering of the penis is suboptimal. Owing to this, we conducted this study using outer preputial skin in the form of Byar's flaps to cover the penile shaft and analysed the results.
Patients and Methods:
This prospective study included 19 patients with CMP operated by a single surgeon using the Byar's flap technique. Following surgery patients were assessed on the 4th post-operative day, at 3 months and 1-year post-operative for cosmetic and functional outcomes. Parental satisfaction about cosmetic results was evaluated using a subjective score. Data were collected and analysed.
Results:
Nineteen patients with CMP were studied with a mean age of 6.3 months. Nineteen patients (100%) patients presented with buried penis and preputial ballooning, malodorous infected urine in 15 (78.9%) patients, thin stream of urine in 17 (89.4%) and dysuria in 12 (63%) patients. One of the patients had associated glanular hypospadias and the other two had isolated chordee. There were no significant complications except for one patient who developed meatal stenosis which was later managed by a meatoplasty. All patients had satisfactory cosmetic appearance.
Conclusion:
CMP is an uncommon but easily identifiable condition. Early surgical correction is recommended to prevent complications. Byar's flap technique yields very good functional and cosmetic results in the management of CMP.
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