AUTHOR=Podestá Miguel Luis , Podestá Miguel 

TITLE=Megaprepuce Reconstruction: A Single Center Experience

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 6 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00064

DOI=10.3389/fped.2018.00064

ISSN=2296-2360

ABSTRACT=.Introduction: Surgical treatment of congenital megaprepuce is challenging and controversial. We report our 10 - year experience treating patients with this deformity using a standardized procedure that has similarities to a technique reported by Smeulders et al (1). Our postoperative complications and mid-term follow-up cosmetic appearance of the genitalia after reconstruction are reviewed.
Material and Methods: Fifteen patients operated on between 2005 and 2015 were evaluated. Age at surgical repair ranged from 3 to 20 months (mean 9). Treatment included unfolding the preputial sac via a ventral approach, excision of redundant inner preputial skin and ventral skin coverage with the outer preputial layer. Twelve patients presented associated partial scrotal engulfment which was simultaneously treated. Mean follow-up was 4.6 years (range 2 to 7years).
Results: Short term complications occurred in 3 patients: scrotal hematoma in one and small skin dehiscence at the penoscrotal junction in two. Skin disruption healed by secondary epithelial ingrowth. All cases resulted in a satisfactory genital cosmetic outcome. There were no late complications. All patients preserved normal external genitalia appearance.
Conclusions: Our experience is in agreement with reports of other authors; suggesting that excision of the inner preputial layer and using the external one for penile coverage provide good and durable mid-term esthetic results in megaprepuce reconstruction. 
Key words: prepuce, penis, congenital abnormalities, children, surgery