PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANGYidong , ZENGLi , HUANGGuizhen , KANGLei ,  HUANGLugang

Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

HUANGLugang, Email: lugang992001@aliyun.com

Keywords：

Webbed penis; Preputial pedicled flap; Phalloplasty; Children

DOI：

10.7507/1002-1892.20160285

Video：

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Objective To evaluate the effectiveness of preputial pedicled flap phalloplasty for repair of severe webbed penis. Methods Between May 2011 and May 2015, 23 boys with severe webbed penis were treated. The age ranged from 2 years and 8 months to 8 years and 3 months (mean, 4 years and 8 months). According to El-Koutby & El Gohary classification, 14 cases were rated as grade 3 simple webbed penis and 9 cases as compound webbed penis (2 cases of type 1, 2 cases of type 2, and 5 cases of type 3). The penis length was 2.1-5.4 cm (mean, 3.4 cm), and the penoscrotal angle was 130-160° (mean, 144°). All the glans could not be exposed. No other urinary system diseases and no history of penile surgery were found in children. All cases underwent one stage preputial pedicled flap phalloplasty. Results After successful correction, the penis length was 3.6-6.4 cm (mean, 4.7 cm); the penoscrotal angle was 90-110° (mean, 97°). Clear skin boundaries were observed at penile and scrotal parts. No web skin or scrotal skin was left on the penis. Primary healing of incision was obtained, with no necrosis of the flap or infection. All cases were followed up 12 to 41 months (mean, 25 months). No penile curvature, abnormal sensation of glans, or recurrence of the penoscrotal angle occurred, and the patients had normal urination. Conclusion Preputial pedicled flap phalloplasty can be used as one stage repair for severe webbed penis. The penis is close to natural state and had satisfactory appearance, avoiding the possibility of long-term edema and penile curvature.

Citation： HUANGYidong, ZENGLi, HUANGGuizhen, KANGLei, HUANGLugang. PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1387-1390. doi: 10.7507/1002-1892.20160285 Copy

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2.	El-Koutby M, Mohamed Amini el G. Webbed penis: A new classification. J Indian Assoc Pediatr Surg, 2010, 15(2): 50-52.
3.	Medina López RA, Campoy Martínez P, Jiménez del Valle U, et al. The webbed penis. A report of a new case. Arch Esp Urol, 1999, 52(1): 68-69.
4.	Bergeson PS, Hopkin RJ, Bailey RB Jr, et al. The inconspicuous penis. Pediatrics, 1994, 92(6): 794-799.
5.	Agrawal R, Chaurasia D, Jain M. Webbed penis: a rare case. Kathmandu Univ Med J (KUMJ), 2010, 8(29): 95-96.
6.	Cimador M, Catalano P, Ortolano R, et al. The inconspicuous penis in children. Nat Rev Urol, 2015, 12(4): 205-215.
7.	Dilley AV, Currie BG. Webbed penis. Pediatr Surg Int, 1999, 15(5-6): 447-448.
8.	Rudin luE, Osipoval Al. Experience of surgical treatment of webbed penis in children. Urologiia, 2003, (2): 36-41.
9.	Jayant R, Asim R, Kannan M. Concealed penis. Pediatric Surgery International, 2002, 18(8): 668-672.
10.	Perlmutter AD, Chamberlain JW. Webbed penis without chordee. J Urol, 1972, 107(2): 320-321.
11.	Wein AJ, Kavoussi LR. Campbell-Walsh Urology. 9th Ed. Philadelphia: Saunders WB, 2007: 3751.
12.	Borsellino A, Spagnoli A, Vallasciani S, et al. Surgical approach to concealed penis: technical refinements and outcome. Urology, 2007, 69(6): 1195-1198.
13.	Lee T, Suh HJ, Han JU. Correcting congenital concealed penis: new pediatric surgical technique. Urology, 2005, 65(4): 789-792.
14.	Brisson P, Patel H, Chan M, et al. Penoplasty for buried penis in children: report of 50 cases. J Pediatr Surg, 2001, 36(3): 421-425.
15.	Yesildag E. It is not "Just Circumcision". Pakistan Journal of Medical Sciences, 2015, 31(4): 975-979.
16.	Li Z, Wei D, Guizhen H, et al. Pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis. J Pediatr Surg, 2012, 47(12): 2289-2293.
17.	曾莉, 肖新辉, 王玉芸, 等.带蒂岛状包皮内板阴茎成形术矫治完全型隐匿阴茎.临床小儿外科杂志, 2011, 10(2): 125-127.

1. Maizels M, Zaontz M, Donovan J, et al. Surgical correction of the buried penis: description of a classification system and a technique to correct the disorder. J Urol, 1986, 136(1 Pt 2): 268-271.
2. El-Koutby M, Mohamed Amini el G. Webbed penis: A new classification. J Indian Assoc Pediatr Surg, 2010, 15(2): 50-52.
3. Medina López RA, Campoy Martínez P, Jiménez del Valle U, et al. The webbed penis. A report of a new case. Arch Esp Urol, 1999, 52(1): 68-69.
4. Bergeson PS, Hopkin RJ, Bailey RB Jr, et al. The inconspicuous penis. Pediatrics, 1994, 92(6): 794-799.
5. Agrawal R, Chaurasia D, Jain M. Webbed penis: a rare case. Kathmandu Univ Med J (KUMJ), 2010, 8(29): 95-96.
6. Cimador M, Catalano P, Ortolano R, et al. The inconspicuous penis in children. Nat Rev Urol, 2015, 12(4): 205-215.
7. Dilley AV, Currie BG. Webbed penis. Pediatr Surg Int, 1999, 15(5-6): 447-448.
8. Rudin luE, Osipoval Al. Experience of surgical treatment of webbed penis in children. Urologiia, 2003, (2): 36-41.
9. Jayant R, Asim R, Kannan M. Concealed penis. Pediatric Surgery International, 2002, 18(8): 668-672.
10. Perlmutter AD, Chamberlain JW. Webbed penis without chordee. J Urol, 1972, 107(2): 320-321.
11. Wein AJ, Kavoussi LR. Campbell-Walsh Urology. 9th Ed. Philadelphia: Saunders WB, 2007: 3751.
12. Borsellino A, Spagnoli A, Vallasciani S, et al. Surgical approach to concealed penis: technical refinements and outcome. Urology, 2007, 69(6): 1195-1198.
13. Lee T, Suh HJ, Han JU. Correcting congenital concealed penis: new pediatric surgical technique. Urology, 2005, 65(4): 789-792.
14. Brisson P, Patel H, Chan M, et al. Penoplasty for buried penis in children: report of 50 cases. J Pediatr Surg, 2001, 36(3): 421-425.
15. Yesildag E. It is not "Just Circumcision". Pakistan Journal of Medical Sciences, 2015, 31(4): 975-979.
16. Li Z, Wei D, Guizhen H, et al. Pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis. J Pediatr Surg, 2012, 47(12): 2289-2293.
17. 曾莉, 肖新辉, 王玉芸, 等.带蒂岛状包皮内板阴茎成形术矫治完全型隐匿阴茎.临床小儿外科杂志, 2011, 10(2): 125-127.

Chinese Journal of Reparative and Reconstructive Surgery

PREPUTIAL PEDICLED FLAP PHALLOPLASTY FOR REPAIR OF SEVERE WEBBED PENIS

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