Simplified Surgical Approach to Congenital Megaprepuce: Fixing, Unfurling and Tailoring Revisited

Ruiz, Eduardo; Vagni, Roberto; Apostolo, Claudio; Moldes, Juan; Rodríguez, Héctor Rafael Céspedes; Ormaechea, María; Giuseppucci, Carlos; Badiola, Francisco de; Bortagaray, Juan; Perea, Carlos

doi:10.1016/j.juro.2011.01.015

Cited by 15 publications

(16 citation statements)

References 14 publications

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“…So far, there have been many techniques described for the correction of a buried penis, but only a few reports are specifically dedicated to the CMP. [ 2 3 4 ] Considering that the outer lay of prepuce was relatively deficient, early circumcision should not be recommended to correct this abnormality, because standard circumcision would remove the skin that was required to resurface the shaft of the penis, which may result in poor cosmesis and a secondary procedure.…”

Section: Discussionmentioning

confidence: 99%

An Arc Incision Surgical Approach in Congenital Megaprepuce

Lin

Zhang

Geng

et al. 2015

Chinese Medical Journal

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Section: Discussionmentioning

confidence: 99%

An Arc Incision Surgical Approach in Congenital Megaprepuce

Lin

Zhang

Geng

et al. 2015

Chinese Medical Journal

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“…In 26 patients with megaprepuce, Ruiz et al ( 10 ) performed an initial dorsal slit or a “limited” circumcision using the inner preputial skin to resurface the penis, based on the technique described by Donahue and Keating ( 11 ) to correct the buried penis. Postoperatively, their cases developed penile skin redundancy, though none required reoperation.…”

Section: Discussionmentioning

confidence: 99%

Megaprepuce Reconstruction: A Single Center Experience

Podestá

2018

Front. Pediatr.

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IntroductionSurgical treatment of congenital megaprepuce is challenging and controversial. We report our 10-year experience treating patients with this deformity using a standardized procedure that has similarities to a technique reported by Smeulders et al. (1). Our postoperative complications and mid-term follow-up cosmetic appearance of the genitalia after reconstruction are reviewed.Material and methodsFifteen patients operated on between 2005 and 2015 were evaluated. Age at surgical repair ranged from 3 to 20 months (mean 9). Treatment included unfolding the preputial sac via a ventral approach, excision of redundant inner preputial skin, and ventral skin coverage with the outer preputial layer. Twelve patients presented associated partial scrotal engulfment, which was simultaneously treated. Mean follow-up was 4.6 years (range 2–7 years).ResultsShort-term complications occurred in three patients: scrotal hematoma in one patient and small skin dehiscence at the penoscrotal junction in two patients. Skin disruption healed by secondary epithelial ingrowth. All cases resulted in a satisfactory genital cosmetic outcome. There were no late complications. All patients preserved normal external genitalia appearance.ConclusionOur experience is in agreement with reports of other authors; suggesting that excision of the inner preputial layer and using the external one for penile coverage provide good and durable mid-term esthetic results in megaprepuce reconstruction.

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“…Many techniques try to take profit from the relative surplus of mucosa for reconstruction by using distally based preputial flaps,[ 14 15 ] including the V flap technique[ 3 ] and preputial unfurling. [ 16 ] The usage of dartos-based vascularized dorsal preputial flaps[ 10 17 18 ] restricts the resection of abnormal dartos and has to be judged in a case-to-case basis. Any redundant mucosal excess may be unsightly.…”

Section: Discussionmentioning

confidence: 99%

Severe forms of concealed penis without hypospadias: Surgical strategies

Jesus¹,

Dekermacher²,

Anderson³

2015

Indian J Urol

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Introduction:Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP.Materials and Methods:Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded.Results:All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed.Conclusion:Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP.

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Simplified Surgical Approach to Congenital Megaprepuce: Fixing, Unfurling and Tailoring Revisited

Abstract: It is possible to correct megaprepuce and achieve an adequate genital aspect with a simple approach of resurfacing the penis with the unfurled, tailored inner prepuce.

Cited by 15 publications

References 14 publications

An Arc Incision Surgical Approach in Congenital Megaprepuce

An Arc Incision Surgical Approach in Congenital Megaprepuce

Megaprepuce Reconstruction: A Single Center Experience

Severe forms of concealed penis without hypospadias: Surgical strategies

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