Efficacy Of Fundiform Ligament Dissection Plus Penoscrotal Flap Transposition For Congenital Buried Penis In Children:a Modified Devine Procedure

Objective To explore the clinical efficacy of fundiform ligament dissection plus penoscrotal flap transposition for childhood congenital buried penis(CCBP).Methods The clinical data was retrospectively analyzed for 88 CCBP patients undergoing the same surgical procedure during January 2006 to August 2018.The median age was 83.5(18 ~174)months.After dissecting fundiform ligament and full extension of shaft,a modified Devine procedure was utilized for transferring penoscrotal flap for dorsal skin defect.Results Fundiform ligament was abnormally attached to deep penile fascia overlaying > 1 /2 of shaft.The mean pre and post-operative lengths of penile shaft were 2.0(1.5,3.0)and 4.0(3.0,4.8)cm respectively.One case of scrotal hematoma occurred.Fortythree cases were followed up for over 1 year.And 39 cases achieved a satisfactory appearance with a satisfaction rate of 90.6%.Two cases were slightly buried and mild scar stenosis occurred in 2 cases.There was no instance of erectile pain or abnormal urination.Conclusion A defect of penile dorsal skin and abnormal attachment of fundiform ligament to shaft are important anatomical features of CCBP.The above procedure is efficacious for congenital buried penis in children.