title: Double-V scrotoplasty for repair of congenital penoscrotal webbing: a hidden scar technique.
abstract: OBJECTIVE
  Penoscrotal webbing (PSW) is a common reason for deferral of neonatal circumcision. Reports of successful procedures and outcomes in the literature are sparse. We have performed double-V scrotoplasty (DVS), a modification of a V-Y technique, in 138 patients with excellent results.
  
  
  METHODS
  We retrospectively reviewed the charts of boys who had undergone DVS for PSW since January 2009 by a single surgeon (S.A.A.). The indications, intraoperative findings, concomitant procedures, outcomes, and complications were recorded.
  
  
  RESULTS
  A total of 138 DVSs were performed. Concomitant genital surgeries included 81 hidden penis repairs and 10 other (hernia, hypospadias, chordee, orchidopexy). The median age at the time of surgery was 9.6 months (6.1 months-9.8 years). Patients were evaluated about 1 month postoperatively. In seven cases (5%), minor skin separation occurred at the penoscrotal junction but all healed completely. Superficial skin infection occurred in one patient. None required reoperation and cosmetic results were subjectively excellent.
  
  
  CONCLUSIONS
  PSW has been corrected in 138 patients without significant complications and with excellent results. This is the largest known peer-reviewed series evaluating a surgical technique for congenital PSW repair. We believe our technique is simple, reproducible, and, with no diverging suture lines lateral to the median raphe, improves cosmesis.
authors.affiliation: Division of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: daryl.mcleod@nationwidechildrens.org.
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: McLeod
authors.affiliation: Division of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA; The Ohio State University Medical Center, Columbus, OH, USA.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Alpert
mesh_terms: D002921:Cicatrix / Q000517:prevention & control*; D002944:Circumcision, Male; D052816:Foreskin / Q000002:abnormalities*; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012611:Scrotum / Q000002:abnormalities*; D012868:Skin Abnormalities / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Concealed penis; Hidden penis; Penoscrotal web