Outcome of circumcision for newborns with penoscrotal web: oblique skin incision followed by penis shaft skin physical therapy shows success

Maizels, Max; Meade, Patrick; Rosoklija, Ilina; Mitchell, M.; Liu, Dennis B.

doi:10.1016/j.jpurol.2019.05.021

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…M Maizels et al reported in their study that circumcision of a straight webbed penis with a slanting up circumcision line leaving slightly more ventral skin to compensate for the web with regular post-operative push down of penile skin for regular cleaning could be efficient. However, the need for this regular procedure may limit the use of this technique and raise the importance of its correction [2].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Z-plasty versus Heineke-Mikulicz scrotoplasty in the management of penoscrotal web in pediatric age group

Elrouby

2024

BMC Urol

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Background The penoscrotal web may be congenital or acquired following excessive ventral skin removal during circumcision. Several surgical techniques were described for the treatment of congenital webbed penis without a clear comparison between their outcomes. This prospective study aimed at comparing the surgical results of Z-scrotoplasty and Heineke-Mikulicz scrotoplasty in the treatment of congenital webbed penis in uncircumcised pediatric patients. Methods Our study included 40 uncircumcised patients who were divided randomly into two groups; Group A included 20 patients who were treated by Z-scrotoplasty and Group B included the other 20 patients who were treated by Heineke-Mikulicz scrotoplasty. All patients were circumcised at the end of the procedure. Results The surgical outcome was good without a significant difference between the two groups in 36 patients. Recurrent webbing developed in one patient of Group A and in three patients of Group B (FEp = 0.605) The only significant difference between the two groups was the operative duration which was shorter in Group B than in Group A (P < 0.001*). Conclusions Treatment of congenital penoscrotal web in the pediatric age group could be done with either Z-scrotoplasty or Heineke-Mikulicz scrotoplasty with satisfactory results, however, without significant difference in the surgical outcomes. Trial registration • Registration Number: ClinicalTrials.gov ID: NCT05817760. • Registration release date: April 5, 2023.

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Section: Discussionmentioning

confidence: 99%

“…stream during childhood and makes future sexual function difficult during adulthood so circumcision without excision of the web is usually contraindicated and web correction is mandatory [2].…”

mentioning

confidence: 99%

Evaluation of Z-plasty versus Heineke-Mikulicz scrotoplasty in the management of penoscrotal web in pediatric age group

Elrouby

2024

BMC Urol

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“…Pediatric urologists can gain particular expertise in circumcision of patients with minor abnormalities including penoscrotal web, which is typically considered a contraindication to a clamp circumcision 12 but can be performed safely with proper technique and experience. 10 In the present study a Mogen clamp was used for all procedures. For urologists who use a gomco or plastibel, anatomical limitations may be somewhat different as these devices may not permit the same level of customization as a Mogen clamp.…”

Section: Discussionmentioning

confidence: 99%

“…Parents view an interactive video that explains suitability assessment, circumcision procedure/possible complications and postprocedure care including penile shaft skin physical therapy. 8,10 Written informed consent is obtained. Oral acetaminophen is administered.…”

Section: Circumcision Clinic and Followup Workflowmentioning

confidence: 99%

“…Mogen clamp particularly helpful in cases of penoscrotal web 10,24 Must assure all adhesions released, and palpation to confirm tip of glans is below clamp Hemostasis Attention to comfort during procedure Use of hemostatic granules at frenulum Explicit Parent Education Shaft skin retraction demonstrated in person, videos, and paper handouts Education on care and expectation likely leads to more consistent home care and improved outcomes 25…”

Section: Measures To Promote Calmness and Comfort During Newborn Circ...mentioning

confidence: 99%

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Development and Outcomes of a Streamlined Outpatient Newborn Circumcision Clinic

et al. 2021

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Introduction: Abnormal penile anatomy is suspected in approximately 20% of newborns whose families desire circumcision, yet there is no clear method to refer such cases for anatomical assessment and circumcision under local anesthesia when safe. The aim of this study was to describe development, implementation and outcomes of a newborn circumcision clinic for boys where concern about anatomical circumcision suitability exists. Methods:The workflow of a pediatric urology outpatient clinic was modified and a circumcision clinic implemented. Staff educational materials and electronic medical record referral templates were created. Circumcision suitability was assessed via checklist, and suitable patients circumcised on the same day. Clinical data were reviewed to evaluate initial implementation and patient outcomes.Results: Of 833 boys evaluated from January 2014 to April 2018, 657 (79%) were suitable to circumcise, all of whom underwent a circumcision. Of those suitable 244 (37%) had normal anatomy. The remaining 413 (63%) had minor anatomical abnormalities, most commonly penoscrotal web (297/657, 45%) and penile raphe deviation (60/657, 9%). No short-term complications were noted. Most (595/657, 91%) returned for followup within 6 weeks after circumcision. Success was achieved in 593/595 boys (99.7%), and 2 boys (0.3%) required acquired buried penis repair. Of the 176 boys with anatomy unsuitable for clamp circumcision (buried penis, chordee or hypospadias), 144/176 (82%) elected for surgical reconstruction.Conclusions: Implementing a newborn circumcision clinic for boys with possible anatomical abnormalities is feasible. Most boys are circumcised safely and successfully without general anesthesia. Operative circumcision under general anesthesia is reserved for boys requiring surgical reconstruction for significant anatomical abnormalities.

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Penile Lengthening; Penile and Testicular Implants; Penile Straightening (Peyronie’s Disease; Scrotoplasty; Complications of Circumcision; Webbing

Weinstein,

Alba,

Rezania

et al. 2024

A Comprehensive Guide to Male Aesthetic and Reconstructive Plastic Surgery

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Outcome of circumcision for newborns with penoscrotal web: oblique skin incision followed by penis shaft skin physical therapy shows success

Cited by 7 publications

References 14 publications

Evaluation of Z-plasty versus Heineke-Mikulicz scrotoplasty in the management of penoscrotal web in pediatric age group

Evaluation of Z-plasty versus Heineke-Mikulicz scrotoplasty in the management of penoscrotal web in pediatric age group

Development and Outcomes of a Streamlined Outpatient Newborn Circumcision Clinic

Penile Lengthening; Penile and Testicular Implants; Penile Straightening (Peyronie’s Disease; Scrotoplasty; Complications of Circumcision; Webbing

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