ORIGINAL ARTICLE   Free access

Minerva Urology and Nephrology 2021 February;73(1):122-7

DOI: 10.23736/S2724-6051.19.03532-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The concealed penis: the “two-corner” surgical technique

Paolo CAIONE ¹ ✉, Yuri CAVALERI ², Simona GEROCARNI NAPPO ¹, Giuseppe COLLURA ¹, Nicola CAPOZZA ¹

¹ Department of Urological Surgery, Bambino Gesù Children’s Hospital and IRCCS, Rome, Italy; ² Unit of Urology, Department of Surgery, Tor Vergata University, Rome, Italy

BACKGROUND: Concealed penis is an uncommon genital abnormality that requires surgical repair. Several techniques are offered but not fully accepted. We present a novel standardized approach that is suitable for concealed penis and penoscrotal webbing.
METHODS: From January 2005 to December 2013, patients presenting concealed penis were treated utilizing the “two corners” technique: through a midline penoscrotal incision, the superficial ventral chordee is removed, freeing the corpus spongiosum till the peno-scrotal angle. Circumferential degloving of the shaft is performed and the scrotal septum is separated from the urethra, allowing the penile shaft to pull out. The new peno-scrotal junction is rebuilt downwards, anchoring the peno-scrotal dartos corners to the peripubic tissue bilaterally and stabilizing the penile lengthening. Tension-free skin coverage is allowed by a series of Z-plasty at the penoscrotal angle avoiding circumcision if not needed.
RESULTS: Forty-nine patients aged 3-14 years (mean age 4.7 years) underwent correction of the concealed penis according to our technique. Of them, 26 were primary and 23 after previous to hypospadias repair or other genital surgery. Penile lengthening varied from 1 to 2.5 cm (median 1.8 cm). Hospital stay varied from 1 to 4 days (mean 1.6 days). Follow-up ranged from 4 to 14 years (median 7.3 years). Forty-five parents were satisfied with the results (92%), while the defect was judged imperfectly repaired in four patients.
CONCLUSIONS: The “two-corners” technique allows easy and effective correction of the concealed penis in both congenital and acquired conditions. It can be performed as outpatient procedure and results are stable at long-term follow-up.

KEY WORDS: Urogenital surgical procedures; Reconstructive surgical procedures; Child