Surgical management of a concealed penis

Abstract

Aim: Satisfaction after primary circumcision is hard to reach. It could be due to incomplete circumcision, other medical causes should be considered. A concealed or buried penis is one of the reasons for dissatisfaction. Although circumcision could be one of the causes of concealed penis, it isn't the main one. It is manly due to: Retraction of the penis by excessive penile facia; insufficient attachment of the penile at the base of the penis; excessive pre-pubic fat. The condition varies in severity and the treatment is always surgical.

Materials and methods: The authors report on their experience in 28 cases (1998-2001) 15 cases type I, congenital which was operated electively with circumcision at 6 months of age, 11 type II concealed penis due to scarring from previous circumcision. Two cases type III (complex cases) involving excessive obesity. Age at surgery ranged from 6 months to 12 years. All patients underwent complete penile degloving anchoring of the deep face of the dermis or the dermis to the proximal part of the penile facia at the base of the penis was used in all patients.

Results: Follow-up ranged from 6 months to 4 years. Good cosmetic results were achieved with good parents and patient satisfaction.

Conclusion: Concealed penis has varied etiology, circumcision could be the initial cause or an aggravating factor and early recognition of this problem can avoid the child circumcision causes the risk of eliminating the skin necessary for reconstruction.

PMID: 12778284