Buried Penis Surgical Correction: Midline Incision Rotation Flaps.

Objective: To improve cosmetic and functional results of buried penis correction in boys using a modified universal surgical approach - Midline Incision Rotation Flaps.
Materials and Methods: We retrospectively analyzed results of 18 patients who underwent buried penis surgical treatment according to the Midline Incision Rotational Flaps technique from 2013 to 2016. The results were assessed by the surgeon 1, 3, 6 months after surgery, then yearly. Parents filled out postoperative survey after 1 month. The surgery commences with a midline longitudinal skin incision on the ventral surface. Following, a circumferential incision along the coronal edge allows to perform full degloving. Excessive subcutaneous fat tissues are removed from the peno-pubic area. Next stage is the formation of the peno-scrotal and peno-pubic angles by fixation of the skin at the base of the penis. Then, the edges of the skin flaps are opened, forming Byar's flaps. The skin defect along the ventral surface is covered with rotated triangular skin flaps with nourishing vessels. Uneven excessive skin is dissected and interrupted skin sutures are placed.
Results and Discussion: The median age of patients was 1.4 years with a median follow-up of 56 months (range 36-72). 16 patients (89%) obtained good results, and 2 patients (11%) - satisfactory. The results showed that size and appearance are close to natural and satisfying to parents of the patients.
Conclusion: The suggested method of buried penis repair using Midline Incision Rotation Flaps technique allows to obtain the most satisfactory both cosmetic and functional results with minimal complication risk.
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