Surgical correction of buried penis: A review of 60 cases

Background/Purpose: The authors reviewed 60 cases of buried penis, treated in a single institution with postoperative follow-up for at least 6 months. The review was aimed at providing information that might help to optimize the results in future surgical correction of this uncommon, but not rare, c ongenital disorder. Methods: From January 1, 1989 to December 31, 1998, 62 boys with buried pen is were treated with 1 of the following procedures: group 1A (n = 6), prepu tial unfurling alone; group 1B (n = 8), modified preputial unfurling; group 1C (n = 12), penoplasty devised by the first author with preservation of t he preputial skin; and group 2 (n = 36), penoplasty with trimming of the in ner preputial skin. Postoperative follow-up of more than 6 months after ope ration was achieved in 60 of 62 patients for a total of 25 patients in grou p 1 (A through C) and 35 patients in group 2. Results: Recurrent buried penis developed in 8 of 60 patients (13%), and re dundant penile skin with or without lymphedema occurred in 18 (30%), The co mplications occurred in 18 of 25 patients (72%) in group 1 (A through C) bu t in only 8 of 35 (23%) in group 2, The difference was significant (P =.001 ). Most of the complications were mild and acceptable. A second procedure w as required in 5 of the 25 patients in group 1 but in none of group 2, The second procedures were required to correct recurrent buried penis in 1 and to resect excess redundant penile skin in 4, Conclusion: The superior results achieved in group 2 suggest that in additi on to penoplasty with adequate fixation of the unfurling prepuce, resection of excess inner preputial skin is required to achieve an optimal outcome i n children requiring surgical correction of buried penis. J Pediatr Surg 36 :426-429. Copyright (C) 2001 by W.B. Saunders Company.