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Webbed penis: A new classification

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      Abstract

      Aim:

      To introduce a new classification for the congenital anomaly of webbed penis and suggest an operative technique that can be planned according to the severity of webbing.

      Materials and Methods:

      A prospective study was conducted in two pediatric surgical units in Egypt and UAE on babies who were referred for circumcision. A preplanned written protocol was designed before commencing the study.

      Results:

      A total of 5,881 babies aged from 1 day to 6 months were seen in two pediatric surgical units. The webbed penis is broadly classified into primary and secondary types. The primary is further subdivided into simple and compound.

      Conclusions:

      We believe that the new classification will serve as a baseline for the anatomical variants and help to streamline the operative procedure accordingly.

      Related collections

      Most cited references 8

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      Surgical correction of the buried penis: description of a classification system and a technique to correct the disorder.

      The concealed penis is a long-standing problem that only recently has begun to receive the attention it deserves. We offer a classification for this general disorder, which facilitates the selection of appropriate surgical procedures for these patients. To correct the most common problem, the buried penis, involves removal of localized deposits of fat from the hypogastrium with open surgical or closed suction techniques followed by anchoring of the skin of the base of the penis to the periosteum of the pubis. During the last year we have used this approach successfully in 7 boys with various forms of penile concealment with good results.
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        Penoplasty for buried penis in children: report of 50 cases.

        The authors report their experience with a large number of children with buried penis and describe their surgical technique. 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 utilizing a surgical technique not described previously. The authors' technique avoids a circumferential incision at the base of the penis, decreasing postoperative edema. The authors also utilize a unique through and through vertical mattress suture at the base of the penis that firmly attaches the shaft skin to the underlying corpora. All patients had a good to excellent outcome with a low postoperative complication rate. One patient fell during the postoperative period and developed a wound dehiscence. Early in the series 3 patients underwent additional procedures for recurrent retraction (6%). All patients experienced some postoperative discomfort as expected. Edema, when present, was mild and resolved within an acceptable period of time. All patients had a good cosmetic result with increased visualization of the penile shaft. A surgical approach to the buried penis is warranted in most circumstances. 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 provides immediate excellent cosmetic results with a low complication rate. The authors do not recommend suprapubic lipectomy either alone or in combination with the buried penis procedure. Circumcision should be avoided in an infant with a definite diagnosis of buried penis.
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          The inconspicuous penis.

          To describe the etiology and management of the group of abnormalities referred to as the inconspicuous penis. Analysis of 19 cases seen over a period of 2 years by chart review. Children's hospital in a major metropolitan area. Nineteen boys referred to two pediatric urologists over a period of 2 years with penises that appeared abnormally small, but on palpation and measurement, were found to have a normal shaft with a normal stretched length. Diagnoses included were buried penis, webbed penis, and trapped penis. Patients ages ranged from 1 week to 13 years. There were eight patients (42%) with trapped penis, and all were complications of circumcision (age 1 week to 7 months). Of nine (47%) patients with buried penis, two had been circumcised prior to diagnosis. One (5%) patient had webbed penis and one (5%) had combined buried and webbed penis. Six trapped penises were surgically repaired, and two resolved spontaneously. Five patients with buried penis had surgical repair, and two are being followed up for probable repair at age 9 to 12 months. Two were not repaired because of medical conditions or parental concerns. The webbed penis was surgically repaired as was the combined buried and webbed penis. The repair were all successful and had no complications. Inconspicuous penis encompasses a group of conditions in which the penis appears small but the shaft can be normal or abnormal in size. Circumcision is contraindicated in these patients until they have been evaluated by a urologist. Further study is needed to determine the natural history of these disorders and to better define which patients will benefit from surgical intervention and at what age.
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            Author and article information

            Affiliations
            Department of Pediatric Surgery, Cairo University Abu Dhabi, United Arab Emirates
            [1 ]Al Noor Hospital Abu Dhabi, United Arab Emirates
            Author notes
            Address for correspondence: Prof. Mohamed Amin El Gohary, Department of Pediatric Surgery, Al Noor Hospital, Abu Dhabi, United Arab Emirates. E-mail: amingoh@ 123456gmail.com
            Journal
            J Indian Assoc Pediatr Surg
            JIAPS
            Journal of Indian Association of Pediatric Surgeons
            Medknow Publications (India )
            0971-9261
            1998-3891
            Apr-Jun 2010
            : 15
            : 2
            : 50-52
            2952775
            20975781
            JIAPS-15-50
            10.4103/0971-9261.70637
            © Journal of Indian Association of Pediatric Surgeons

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Categories
            Original Article

            Surgery

            concealed penis, webbed penis, buried penis

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