title: Adult prepuceplasty: comparison of outcomes of standard prepuceplasty and foreskin Z-plasty.
abstract: OBJECTIVE
  To compare the clinical and patient-reported outcomes from standard prepuceplasty and foreskin Z-plasty.
  
  
  METHODS
  Consecutive standard prepuceplasty (n = 22) and Z-plasty (n = 12) procedures performed from September 2005 to December 2010 were analyzed. The patient and operative data were collated, together with the results of a patient questionnaire inquiring about the postoperative complications, postoperative pain, remaining foreskin tightness in the flaccid or erect penis, cosmetic appearance after surgery, and the need for later circumcision.
  
  
  RESULTS
  The median follow-up period was 26 months for standard prepuceplasty and 16 months for Z-plasty. Of the 22 patients in the standard prepuceplasty group and 12 patients in the Z-plasty group, 5 (22.7%) and 1 (9.1%) requested circumcision (P = .33), respectively. One man in each group underwent revision standard prepuceplasty. Patients undergoing the 2 procedures reported no significant differences for the questions relating to postoperative pain and foreskin tightness in the flaccid or erect penis. However, the cosmetic appearance after Z-plasty, assessed using a Likert scale question, were "good" or "very good" compared with "acceptable" for the standard group (P = .005).
  
  
  CONCLUSIONS
  Prepuceplasty can be used successfully in well-selected patients. In the present series, 82% of men avoided circumcision. Z-plasty resulted in fewer circumcisions and a significantly better cosmetic appearance than standard prepuceplasty.
authors.affiliation: Department of Urology, Western General Hospital, Edinburgh, United Kingdom.
authors.forename: Grant D
authors.initials: GD
authors.lastname: Stewart
authors.forename: Jonas
authors.initials: J
authors.lastname: Gruthölter
authors.forename: Roland
authors.initials: R
authors.lastname: Donat
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male; D052816:Foreskin / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D055815:Young Adult