301 Outcomes of Modified Glans Hypermobility Correction at Time of Initial IPP

Abstract

Glans hypermobility correction at time of initial IPP is rarely performed. We describe a modification to Trost’s glanspexy technique and outcomes of patients corrected at the time of their initial IPP placement. To describe and assess outcomes of a modification to Trost’s glanspexy technique utilized at the time of initial IPP placement. Trost’s glanspexy technique involves two dorsolateral incisions and a U stitch through the glans anchored at both incision sites to correct classic SST. However, for lateral hypermobility, the U stitch is replaced with a single plication stitch. For ventral hypermobility 2 plication stitches with two incisions are used (as a U stitch would pierce the urethra). 2-0 Ethibond is used after dissecting down to squeaky clean tunica albuginea as the ethibond requires 2 layer coverage. An aggressive first bite stitch is taken at the tip of the uninflated cylinder (the tip is non fluid filled and not at risk) and the second bite is subdartos, incorporating a healthy portion of glans and coming back out near the entry point. The suture is tied down and hypermobility reassessed with device inflated. Additional sutures are sometimes necessary. Removal of excess foreskin or indeed circumcision revision can also aid correction.