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. 2008 Mar 4;8:6.
doi: 10.1186/1471-2490-8-6.

Sutureless Prepuceplasty With Wound Healing by Second Intention: An Alternative Surgical Approach in Children's Phimosis Treatment

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Free PMC article

Sutureless Prepuceplasty With Wound Healing by Second Intention: An Alternative Surgical Approach in Children's Phimosis Treatment

Efstratios Christianakis. BMC Urol. .
Free PMC article

Abstract

Background: A new technique for the treatment of children's phimosis is presented that minimizes the repairing time, the postoperative complications and maintains the physical foreskin appearance intact.

Methods: Eightyseven children with phimosis were treated with this new developed technique, between 2003 and 2005. Sutureless prepuceplasty creates a permanent surgical extension of the close prepuce. Stretching and retraction of phimotic foreskin reveals a tight prepuce ring that is cutting in its dorsal surface longitudinally. Rarely triple symmetric incisions in the preputial outlet are necessary. The foreskin is loose and moves absolutely free in bilateral courses. The wounds are healing by second intention. Antisepsis, steroids and Elicina cream, (which contains allantoin, collagen, elastin, glycolic acid and vitamins A, D, and E) should apply daily, for twenty to thirty days.

Results: The foreskin is moving in centripetal or efferent courses absolutely loosely, painlessly and bloodlessly. The mean time of follow-up was 27 months (one to four years). No complications were observed.

Conclusion: Sutureless prepuceplasty may present an acceptable alternative in children's phimosis reconstruction.

Figures

Figure 1
Figure 1
Photo of a young child with severe phimosis. The foreskin cannot be retracted to exposure the glan.
Figure 2
Figure 2
Foreskin is retracted under anesthesia with constriction of the penile shaft forming a clepsydras shape. A longitudinally dorsal incision is made including the skin and dartos. Tissue stretching in transverse direction is performed by using a mosquito forceps, until the clepsydrae ring disappears circumferentially.
Figure 3
Figure 3
Photo of the stenotic ring of the prepuce.
Figure 4
Figure 4
Photo of the longitudinally dorsal incision that is made including the skin and dartos. The dissection and the dilation of the prepuce are performed to ensure looseness of the foreskin during opening and closure.
Figure 5
Figure 5
Photo of haemostasis performed with a heatened probe.
Figure 6
Figure 6
Photo of the final result, six (6) months with the foreskin retracted.
Figure 7
Figure 7
Photo of the final result, six (6) months later with the foreskin closed.

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