title: "Trident" preputial plasty for phimosis in childhood.
abstract: OBJECTIVE
  To evaluate the functional and cosmetic result of modified-triple incision preputial plasty for surgical management of phimosis in children.
  
  
  METHODS
  This prospective study involved all consecutive children (age 3-15) with phimosis, managed at our Institution in a one-year period. All patients unable to retract the foreskin and symptomatic with episodes of posthitis or balanoposthitis or ballooning of the foreskin with voiding were initially included. After a two-month trial of topic corticosteroids treatment, for patients refractory to conservative ointment treatment, "trident" preputial plasty was offered. This procedure combines two lateral Z-plasty and one middle Y-V plasty. All the procedures were performed as a day care, in general anaesthesia by two senior surgeons. Outpatient follow-up controls were scheduled at 1 and 2 week, 1, 6 and 12 months after surgery, respectively.
  
  
  RESULTS
  A total of 41 patient were enrolled. Mean operative time was 24 minutes (range 15-43). At 12-month follow-up, all but one patients (97.6%) was able to retract the prepuce. Cosmetic and functional results were satisfactory.
  
  
  CONCLUSIONS
  In selected group of children with phimosis, the "trident" preputial plasty provided excellent cosmetic and functional result. Adequate retraction of the prepuce by the patients soon after surgery is mandatory.
authors.affiliation: Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Pedersini
authors.affiliation: Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy. Electronic address: parfil@hotmail.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Parolini
authors.affiliation: Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy.
authors.forename: Anna Lavinia
authors.initials: AL
authors.lastname: Bulotta
authors.affiliation: Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Alberti
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D052816:Foreskin / Q000601:surgery*; D006801:Humans; D008297:Male; D061646:Operative Time; D010688:Phimosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Children; Phimosis; Prepuce; Preputial plasty; Trident plasty