How We Do Buried Penis Reconstruction in Children: A Novel Technique

Abstract

Buried penis is a pathology for which several reconstructive techniques are described. We described a novel technique involving complete separation of dartos fascia from the skin and penis and excision of dartos fascia until penile fixation to pubic region after complete degloving of penis to eradicate the abnormal attachments of the dartos muscle to the corporal bodies and evaluated the efficacy and safety of our technique. From June 2009 and February 2015, 28 patients underwent surgical repair of buried penis with our novel technique. We administered a questionnaire asking questions about penile size, morphology, and voiding status to evaluate parental satisfaction. The mean age of patients at the time of operation was 9.50±2.09 years, and the mean duration of follow-up was 23.27±16.75 months. The mean satisfaction grades for penile size, morphology, and voiding function were improve (p < 0.05) (Fig. 2). The mean preoperative satisfaction grade concerning penile size was 0.82±0.76, and it improved postoperatively to 2.67±0.52 at the last follow-up (p < 0.001). The mean preoperative satisfaction grade for penile morphology was 0.86 ± 0.55, which improved to 2.12±0.40 at the last follow-up visit (p < 0.001). The mean preoperative satisfaction grade for voiding function was 1.10±0.72, which improved to 2.94±0.86 at the last follow-up visit (p < 0.001). There were no complications such as postoperative infection and tissue necrosis. Edema developed in 2 patients, but resolved spontaneously after 1 month. Our method of buried penis correction was found to be technically feasible and safe. It results in a good cosmetic appearance and excellent postoperative satisfaction rates in terms of size, morphology, and voiding function. Further research is needed to understand its pathophysiology.