Abstract
INTRODUCTION AND IMPORTANCE: Circumcised concealed penis (CP) patients will have insufficient penile shaft skin, causing difficulty to perform reconstructive surgery. There hasn't been a single, widely acknowledged surgical procedure for all varieties of CP repairs until lately. We report a novel surgical technique with combination of penile and scrotal skin flap for circumcised concealed penis. CASE PRESENTATION: A 9-year-old boy concealed penis patient with history of circumcision was corrected with combination of penile and scrotal flap. Three important steps in this technique include preparation of penile skin flap, preparation of scrotal skin flap and skin coverage. Indicators were measured with detail such as the pre- and post-operative penile length, as well as the intraoperative time and bleeding during the operation. After surgery patient achieved a clinically significant improvement in the appearance post operatively including penile length and morphology. During 3 months of follow up there are no complication such as necrosis, contracture, voiding and erectile function are also maintained during follow up. CLINICAL DISCUSSION: Acquired concealed penis cases usually occur as a complication of neonatal circumcision which causes entrapment of penis by postoperative cicatricial scar over the glans. A new combination technique by using scrotal and penile flap allows mobile and richly vascularized skin of the scrotum to cover defects of penis shaft. CONCLUSION: This technique is well tolerated for the case. The lack of skin coverage after circumcision procedure can be overcome while preserving all of the rest penile skin.