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Clinical Comparison of Scrotal Advancement Flap and Dorsal Transverse Preputial Island Flap for Severe Concealed Penis in Children: A Single-Center Retrospective Analysis

Year: 2025

Type: article

Abstract: OBJECTIVE: To compare the clinical outcomes of the scrotal advancement flap (SAF) and the dorsal transverse preputial island flap (DTPIF) in the surgical management of severe concealed penis (SCP) in pediatric patients. METHODS: Seventy-two children with SCP treated between 2020 and 2023 were retrospectively reviewed. Patients were divided into Group A (SAF, n = 45) and Group B (DTPIF, n = 27). Operative time, penile length parameters (bared penile length [BPL], stretched penile length [SPL], and concealed index [CIs]), complications, and parental satisfaction using the Modified Pediatric Penile Perception Score (MPPPS) were analyzed. RESULTS: The mean operative time was significantly longer in Group B than in Group A (112.67 ± 6.37 vs 87.64 ± 5.91 minutes, P <.001). Both groups demonstrated significant postoperative improvements in BPL, SPL, and CIs (P <.001). Overall complication rates did not differ significantly (33.33% vs 51.85%, P = .121), but the distribution of complications varied: wound dehiscence was more frequent in Group A (7 cases, P = .04), whereas persistent preputial edema (6 cases, P = .002) and partial flap necrosis (3 cases, P = .049) occurred exclusively in Group B. Parental satisfaction scores were comparable between groups (P >.05). CONCLUSION: Both flap techniques are effective for correcting SCP, significantly improving penile appearance and length. The SAF is simpler but carries a higher risk of wound dehiscence under tension. The island flap reliably covers large skin defects but is more complex and associated with edema and vascular risks. The choice of procedure should be individualized based on the patient's anatomy and the surgeon's expertise.

Source: Urology

DOI: 10.1016/j.urology.2025.12.021

Authors: Zhenjie Chu, Honglong Ma, Xiao Wang, Rui Tang

Institution: First Affiliated Hospital of Wannan Medical College

Language: English

Topic: Urological Disorders and Treatments

Subfield: Urology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,200