The Characteristics and Distribution of Nerve Plexuses in the Dartos Fascia From Concealed Penis Children.

Wenfang Huang,Daxing Tang,Weizhong Gu

doi:10.3389/fped.2021.705155

Abstract

The purpose of this study is to analyze the nerve plexus distribution in dartos fascia of concealed penis (CP). A total of 28 CP patients met ASA categories I and II were included, with median age of 3.5 years (8 months−5 years). During the surgery, tissue samples of dartos fascia at points 3, 6, 9, and 12 o'clock of the penile shaft were collected. Standard hematoxylin and eosin (H&E) staining and S-100 immunohistochemical staining were used to analyze the nerve plexus distribution among different positions. The number of nerve plexuses in superficial fascia collected at the 6 o'clock position of the penile shaft was the most abundant among four positions (median 7.25, range 1–24). The abundant nerve plexuses in the dartos fascia of CP patients, especially at the 6 o'clock position, indicate that the surgery on the preputial frenulum should avoid damage to the dartos fascia, as it might be related to maintain the erection and sexual function in adolescence.

Highlights

Concealed penis (CP) is a relatively rare congenital malformation in children and has many unclear causes
The parents or legal guardians of the patients participating in this study provided written informed consent
hematoxylin and eosin (H&E) staining showed that nerve plexuses were distributed on the dartos fascia of the penis in the concealed penis (CP) (Figure 2A)

Summary

Introduction

Concealed penis (CP) is a relatively rare congenital malformation in children and has many unclear causes. Spinoit et al showed histological abnormalities of the dartos fascia in 74% of CP patients, and the dartos layer of the penis became inelastic, thereby preventing the forward extension of the penis and trapping it under the pubic bone [7]. CP surgical procedures include complete penile peeling, removal of excess suprapubic fat, reconstruction of penile skin with local flaps, and fixation of penile skin at the pubic bone and scrotal corner [2, 7, 8]. These surgical techniques have reported satisfactory results with almost no complications [8,9,10]. Excessive defrosting of the foreskin may lead to a postoperative penile retraction, inversion of the foreskin caused by a lymphocytic obstruction (short-term), and

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