Modified Brisson technique for concealed penis in children

Abstract

Objective To investigate the corrective effect of modified Brisson technique to treat concealed penis in children. Methods From July 2014 to July 2016, selected 12 patients (3-10 years old, mean 7.2 years old) with concealed penis were surgically treated with the modified Brisson technique in the Second Affiliated Hospital of Nanjing Medical University.Their clinical manifestations included the penis buried below the surface of prepubic skin which can be palpated and visualized through pushing the skin around the penis to the pubis and the short foreskin which was not attached to the penile corpus cavernosum.Patients with other conditions such as obesity and penial agenesis that caused buried penis were excluded from the study.The modified Brisson technique consisted of 4 steps.Ventral incision was used to gradually slit the narrow ring of the prepuce and to expose the glans followed by circumfe-rential inner foreskin incision made below the coronary sulcus of penis then the foreskin stripping released the corpus cavernosum.Finally the skin coverage was accomplished by posthioplasty.The operation time, blood loss, complications, postoperative treatments and followed-ups were retrospectively analyzed. Results For all the 12 patients, the operations were successful, lasting 40 to 60 minutes.The bleeding was about 5 to 10 mL and there was no operation-related complications like bleeding and infection of incision.Satisfactory cosmetic outcomes were obtained without retraction and the scars were similar to those of circumcision.All patients had penile lymphedema postoperatively which disappeared within 6 months after operation.Follow-up ranged from 6 months to 1 year, and there were no complications like skin necrosis and contracture or voiding difficulty. Conclusions The modified Brisson technique for concealed penis repair is technically easy and safe.In addition, it provides a good cosmetic appearance, functional outcomes and excellent postoperative satisfaction grades. Key words: Brisson technique; Concealed penis; Child