Concealed Penis in Pediatric Age Group

Study Overview
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Brief Summary
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Background: Comparison between three different surgical techniques in the management of concealed penis. Methods: This prospective interventional non-randomized study included 150 pediatric patients with concealed penis. They were distributed equally into three groups; group A; patients treated by phallopexy only, group B; patients treated by complete dissection and excision of dartos fascia & group C; patients treated by both phallopexy and dartos excision.

Detailed Description
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Background: Comparison between three different surgical techniques in the management of concealed penis. Methods: This prospective interventional non-randomized study included 150 pediatric patients with concealed penis. They were distributed equally into three groups; group A; patients treated by anchoring the penile skin dermis to Buck's fascia at the penile base at 3 & 9 o'clock points using PDS 5/0 (phallopexy), group B; patients treated by complete dissection and excision of dartos fascia & group C; patients treated by phallopexy as in group A after complete dissection and excision of dartos fascia. Follow-up at the end of the 1st post-operative week and then monthly for 6 months as regards penile skin congestion and/or necrosis, wound infection, edema, and/or re-retraction was carried out.

Official Title
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Concealed Penis in Pediatric Age Group; A Comparison Between Three Surgical Techniques

Conditions
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Pediatric ALL, Surgery, Urologic Diseases

Intervention / Treatment
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* Procedure: Circumcision in concealed penis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with a buried penis at or below the pubic skin level with a stretched penile length for all of them within the normal range according to their ages as titrated in the literature Exclusion Criteria: Patients with any associated anomalies like hypospadias, torsion, penoscrotal web, micropenis, mega-prepuce, or chordae were excluded from the study.
Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Phallopexy group<br>phallopexy only | Procedure: Circumcision in concealed penis<br>* comparison of three surgical techniques (as described in the arms) in the management of concealed penis in pediatrics<br>|
| Experimental: Dartos excision group<br>complete circumferential dissection and excision of dartos fascia only | Procedure: Circumcision in concealed penis<br>* comparison of three surgical techniques (as described in the arms) in the management of concealed penis in pediatrics<br>|
| Experimental: Combined phallopexy and dartos excision group<br>phallopexy as in patients of group A but after complete dissection and excision of dartos fascia | Procedure: Circumcision in concealed penis<br>* comparison of three surgical techniques (as described in the arms) in the management of concealed penis in pediatrics<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-operative appearance of penile skin congestion and/or necrosis | Repeated and regular monthly examination of the patients as regards persistent bluish penile discoloration and or loss of penile skin viability. Also a questionnaire of parents about penile skin color, loss of skin, and/or appearance of any abnormal tissues | 6 months | 
| Wound infection | Repeated and regular monthly examination of the patients as regards the appearance of any penile skin infection and/or pyogenic discharge. Also a questionnaire of parents about the appearance of penile skin redness, pyogenic discharge, and/or the appearance of any pyogenic membranes | 6 months | 
| Penile edema | Repeated and regular monthly examination of the patients as regards the appearance of penile skin edema. Also a questionnaire of parents about any increase of penile girth than the usual | 6 months | 
| Penile re-retraction | Repeated and regular monthly examination of the patients as regards the development of any penile re-retraction in the form of retraction of the penis to or beneath the level of pubic skin. Also, a questionnaire of parents about this finding was done | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Concealed, phallopexy, dartos excision, degloving, penile re-retraction