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Introduction:
There are a myriad of techniques to correct the concealed penis. Those patients with significant penoscrotal webs, invariably have need for a scrotoplasty as part of their corrective surgery. In an attempt to obviate scrotoplasty, the author has modified the surgical approach to these patients and herein reports on the preliminary results.
Materials and methods:
From July 2014 through March 2015, 20 boys ages 6 months to 6 years (mean 10 months), underwent correction of penile concealment with the presence of significant scrotal webbing using a paraphimotic band incision dorsally and ventrally to avoid scrotoplasty. By retracting the foreskin proximally, paraphimosis was created and, by incising each band at 12 and 6 o'clock, the scrotal web appeared to drop back to a more normal anatomic configuration. The remaining shaft was degloved and locking sutures were placed at 12, 5 and 7 o'clock at the base of the penis in buck's fascia and affixed to the corresponding dermis of the abdominal wall/shaft skin junction using 4-0 PDS suture. The shaft skin is then unfurled and the excess skin excised with the circumcision defect approximated with fine chromic catgut.
Results:
Follow-up ranged from 3 weeks to 6 months (mean 3 months). All patients had excellent penile shaft exposure and no significant webbing noted.
Conclusions:
The paraphimotic band modifcation for reconstruction of the concealed penis appears to be successful and reproducible in the short term. Futher follow-up is necessary to confirm that this procedure stands the test of time.