Objective To evaluate the outcomes of penoplasty with penile frenulum lengthening for concealed penis in children.Methods From March 2014 to March 2016,a total of 233 patients with concealed penis who enderwent penoplasty with penile frenulum lengthening were enrolled.The everage age at surgery was 3.7 years (1 year and seven months-12 years).There were 73 cases with obvious small urinary stream,dysuria,or prepuce dilatation when urinating;41 cases with the history of recurrent infections of prepuces;and 9 cases with the history of urinary tract infections.During operation,incise the back side center of the outer plate of the prepuce and fully release the ring-type funicular tissue between the inner and outer plates of the prepuce to make the inner plate fully swell out.After the prepuce is upturned,cut the penile frenulum at the coronary sulcus.Make a V-shaped cut on the left and right sides of the far end of the outer plate cut of the prepuce from the cut of the penile frenulum.Lengthen penile frenulum after the prepuce is pressed off.Cover the dorsal side of the penis with the inner plate of the prepuce and cover its ventral side with its outer plate.Results Mean surgical time for patients was 38 min (30-55 min).All operations were completed successfully and the post-operation follow-up lasts 3 months to 2 years.For all cases,the appearance of the penis is improved.The penis stretches out,the balanus is exposed,the prepuce has no obvious swelling and the scrotum angle of the penis is obvious.No phimosis relapses and there is no obvious scar hyperplasia.Conclusions This surgical procedure is an effective treatment choice for concealed penis.It provides a good cosmetic result.

Objective:To compare the effectiveness of modified Sugita and modified Shiraki in the treatment of severely concealed penis in children.Methods:A retrospective study was carried out on 72 children with congenital severely concealed penis, who were treated in the Department of Urology, Xuzhou Children′s Hospital Affiliated to Xuzhou Medical University from September 2016 to June 2021.Among them, 32 cases were treated with modified Sugita (modified Sugita group) and 40 cases were treated with modified Shiraki (modified Shiraki group). There was no significant difference in the age, body mass and body mass index between the 2 groups (all P>0.05). The operation time, increased length of the exposed part of the penis after operation, score of parental satisfaction half a year after operation (obtained by using the Likert scale) and postoperative complications (classified according to the modified Clavien-Dindo classification) were compared between the 2 groups.Measurement data comparison between groups were performed by t test, counting data were analyzed by Chi- square test. Results:The operative time of the modified Sugita group and the modified Shiraki group were (50.00±8.03) min and (40.30±9.27) min, respectively.The operative time was significantly different between 2 groups ( t=4.107, P<0.05). The increased length of the exposed part of the penis after operation was (1.80±0.30) cm in the modified Sugita group and (1.90±0.33) cm in the modified Shiraki group, and no significant difference was found between the 2 groups ( P>0.05). Six months after operation, the parental satisfaction score was (4.60±0.56) points in the modified Sugita group and (4.60±0.59) points in the modified Shiraki group.There was no significant difference in the parental satisfaction score between 2 groups ( P>0.05). In 72 cases, only 5 cases had grade Ⅰ complications.Postoperative complications were also not significantly different between the 2 groups ( P>0.05). Conclusions:After treating severely concealed penis in children with modified Sugita and modified Shiraki, the penis has a good appearance.These two surgeries have high parental satisfaction and low complications.They are easy to implement in clinical practice.The operation time of modified Shiraki is shorter than that of modified Sugita.

Objective:To introduce the application of a modified scrotoplasty for children with webbed penis.Methods:Retrospective study was carried out.The treatment results of 58 children with webbed penis in Department of Urology, the Affiliated Xuzhou Children′s Hospital of Xuzhou Medical University from June 2012 to April 2018 were analyzed.A total of 26 children with webbed penis and phimosis were treated with circumcision combined with modified scrotoplasty as modified scrotoplasty group, and 32 children with webbed penis and phimosis were treated with V-Y scrotoplasty as V-Y scrotoplasty group.The curative effect of webbed penis was compared between the two groups.Results:The operation time of V-Y scrotoplasty group and modified scrotoplasty group were (26.0±2.4) min and (28.0±3.2) min; the increased penis length in the horizontal position in the two groups were (0.30±0.06) cm and (0.40±0.06) cm; the score of parents′ satisfaction were (3.80±0.47) scores and (4.70±0.56) scores, there were significant differences in the average operation time, the increased penis length in the horizontal position and the score of parents′ satisfaction between the two groups ( t=2.703, 6.061, 6.652; all P<0.05). There was no significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:Circumcision combined with modified scrotoplasty is used to repair webbed penis, which results in a good postoperative appearance, high parent satisfaction and easy clinical implementation.