title: Surgical approach to the congenital megaprepuce.
abstract: The megaprepuce (MP) is a very rare malformation of unknown aetiology, with anatomical findings similar to those observed in the congenital buried penis (BP). The aspect of this entity and the symptoms are rather typical: the penis is totally buried and before micturition an evident pubic and scrotal swelling denounces the urine collection in an abnormal preputial cavity surrounding the entire shaft. Early surgery is recommended, in order to deal with functional and cosmetic aspects. The very diminutive phallus is the most important cause of family anxiety. The authors present six infants, aged 5, 12, 13, 18, 20 and 43 months, operated upon for MP. The surgical approach consisted in the complete exteriorization of the shaft with section of the penile ligament, the restoring of the pubo-penile and peno-scrotal angles and the tailoring of the cutaneous cylinder. No intra- or postoperative complications were observed. Late functional and cosmetic results were judged satisfactory by both parents and surgeons. The surgical approach to BP is not simply transferable to the correction of MP. The cosmetic arrangement of the shaft skin is the more difficult step of the MP correction in order to avoid postoperative complications and an unsatisfied cosmetic appearance.
authors.affiliation: Andrological Surgery Unit, Bambino Gesù Children's Hospital, Piazza S. Onofrio, 4-00165 Rome, Italy. ferro@opbg.net
authors.forename: Fabio
authors.initials: F
authors.lastname: Ferro
authors.forename: Antonio
authors.initials: A
authors.lastname: Spagnoli
authors.forename: Ioannis
authors.initials: I
authors.lastname: Spyridakis
authors.forename: Pietro
authors.initials: P
authors.lastname: Atzori
authors.forename: Luisa
authors.initials: L
authors.lastname: Martini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borsellino
mesh_terms: D002675:Child, Preschool; D004954:Esthetics; D006801:Humans; D007223:Infant; D008297:Male; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps