Y-V preputioplasty for adult phimosis: a review of 89 cases.
OBJECTIVE
Numerous surgical techniques have been proposed for preputial relief to avoid circumcision. We aimed to review the indications, techniques, and outcomes of Y-V preputioplasty for men with phimosis treated at our institution between 1995 and the present.


METHODS
We retrospectively examined the case notes of 89 patients who underwent Y-V preputioplasty since 1995. Indication, technique, and immediate outcomes were recorded. We have subsequently attempted to contact these patients for the completion of a satisfaction questionnaire.


RESULTS
All case notes were retrieved; 87 of 89 procedures were undertaken by a single surgeon (I.A.). The median age at operation was 29 years (range, 18-84 years) and median follow-up was 4 years. Seven patients required revision surgery (3: Y-V preputioplasties; 2: circumcisions; 1: adhesion division; and 1: frenuloplasty), whereas 2 patients reported unresolved symptoms but have not undergone additional procedures. Currently, we have successfully contacted 31 of 89 (35%) patients by telephone. These cases appear to have similar demographic features to the whole group. All agreed to complete a satisfaction questionnaire, and 30 replies were received. Overall, 12 patients (40%) were very satisfied and 10 (33%) were satisfied, whereas 4 (13%) were indifferent and 4 (13%) were dissatisfied. Two patients have subsequently undergone circumcision. Twenty-one (70%) patients described their cosmetic result as very good or good, and 22 (73%) patients would recommend the operation to a friend. Dissatisfaction with the procedure seemed to be associated with pre-existing erectile dysfunction, and not retracting the foreskin postoperatively.


CONCLUSIONS
Y-V preputioplasty would seem a good alternative to circumcision for men with phimosis who wish to preserve their foreskin.
Munro
Nicholas P
NP
Airedale General Hospital, Steeton, Keighley, United Kingdom. nic@munron.plus.com
Khan
Hassan
H
Shaikh
Nick A
NA
Appleyard
Ian
I
Koenig
Philip
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052816:Foreskin / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010688:Phimosis / Q000601:surgery*; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male / Q000379:methods