Penoplasty for buried penis in children: Report of 50 cases

Purpose: The authors report their experience with a large number of childre n with buried penis and describe their surgical technique. Methods: Fifty consecutive cases of buried penis that occurred between 1993 and 1999 were analyzed by chart review. Age at the time of surgery was 11 months to 13 years. Each patient underwent elective surgical repair utilizi ng a surgical technique not described previously. The authors' technique av oids a circumferential incision at the base of the penis, decreasing postop erative edema. The authors also utilize a unique through and through vertic al mattress suture at the base of the penis that firmly attaches the shaft skin to the underlying corpora. Results: All patients had a good to excellent outcome with a low postoperat ive complication rate. One patient fell during the postoperative period and developed a wound dehiscence. Early in the series 3 patients underwent add itional procedures for recurrent retraction (6%). All patients experienced some postoperative discomfort as expected. Edema, when present, was mild an d reserved within an acceptable period of time. All patients had a good cos metic result with increased visualization of the penile shaft. Conclusions: A surgical approach to the buried penis is warranted in most c ircumstances. There are psychological benefits to both the patients and the parents. Although the authors perform the procedure as early as 11 months, it can be performed safely at 3 months. The procedure reported here provid es immediate excellent cosmetic results with a low complication rate. The a uthors do not recommend suprapubic lipectomy either alone or in combination with the buried penis procedure. Circumcision should be avoided in an infa nt with a definite diagnosis of buried penis. J Pediatr Surg 36:421-425. Co pyright (C) 2001 by W.B. Saunders Company.