title: Pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis.
abstract: OBJECTIVE
  To evaluate the effect of pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis.
  
  
  METHODS
  We retrospectively reviewed 97 consecutive patients with completely concealed penis, which had been surgically corrected between November 2004 and January 2012. All patients were repaired using 2 surgical methods: 18 with Shiraki's operation and 79 with a technique of pedicled foreskin skin flap.
  
  
  RESULTS
  With 1 month to 7 years (mean 18 months) follow-up, the 18 cases treated by Shiraki's operation had satisfactory exposed penile shaft but too much incision and obvious edema. The 79 cases treated by pedicled foreskin skin flap uniformly reported satisfaction with the operative results. They found the surgical repair was successful in appearance and improved hygiene, accessibility, and penile exposure. There was no recurrence to the pre-treatment condition, or any chordee, penile distortion, trapped penis, erectile abnormalities, or voiding complications in any case. The pedicled skin flap was without ischemia or necrosis and yielded no post-operative wound infections, wound separation, or unsightly scarring. Slight edema and swelling of the flap were common, but these issues completely resolved by 3 weeks.
  
  
  CONCLUSIONS
  Numerous operative procedures have been described and adopted for the management of completely concealed penis, but the pedicled skin flap phalloplasty can achieve maximum utilization of prepuce to assure coverage of the exposed penile shaft. It has fewer complications, achieving marked aesthetics and often functional improvement. This suggests pedicled foreskin skin flap for phalloplasty is a relatively ideal means for treating completely concealed penis.
authors.affiliation: Department of Pediatric Surgery, West China Hospital of Sichuan University, Wai-nan Guo-xue Xiang 37#, Chengdu, Sichuan, 610041, PR China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Li
authors.forename: Dan
authors.initials: D
authors.lastname: Wei
authors.forename: Huang
authors.initials: H
authors.lastname: Guizhen
authors.forename: Yuan
authors.initials: Y
authors.lastname: Miao
authors.forename: Huang
authors.initials: H
authors.lastname: Lugang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D015331:Cohort Studies; D005500:Follow-Up Studies; D052816:Foreskin / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010413:Penis / Q000002:abnormalities / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*