- Preputioplasty
which either has not relaxed during childhood and adolescence or has re-narrowed after sexual maturity.
Preputioplasty is a treatment for
phimosis in the alternative tocircumcision and superincision or dorsal slit
*which is conservative, non-traumatic and less invasive and can be performed on an outpatient basis under local anaesthetic in a doctor's office and
*has the advantage of healing very quickly with little or no significant cosmetic alteration to the appearance of the penis.Methods of performing preputioplasty
, techniques also used in reconstructive surgery to loosen constricting scar tissue following traumatic burns.
However, Y-plasty and Z-plasty require a degree of surgical sophistication that physicians in general practice may lack.
More commonly it simply consists of one or more very short longitudinal incisions which release the stenosis — the constricting ring of tissue — in the foreskin and are closed transversely: [|] is closed and sutured as [—] . Only one incision is shown in Figure 3; if two or more such incisions are made this will prevent a V-shaped indentation at the opening of the foreskin when the penis is not erect.
The opening of the foreskin is now normally wide enough for the foreskin to be easily retracted. The foreskin is also slightly shorter (by half the length of the longitudinal incisions which are now closed transversely) because the widening of the phimotic ring takes up some foreskin length.
Comparison with dorsal slit
By contrast, the dorsal slit (sometimes referred to in anthropological literature as superincision) leaves the glans penis wholly exposed and the appearance of a circumcised penis from the dorsal aspect.
However, no tissue is removed. The entire tissue of the foreskin gathers after a dorsal slit on the underside of the shaft, and gives the appearance of a turkey neck from a lateral or anterior view or in erection.
Preputioplasty versus circumcision and dorsal slit
European physicians and surgeons have carried out preputioplasties for many years in a social environment in which circumcision is widely considered anomalous.
Preputioplasty is appropriate in the majority of cases of non-retractile foreskin
*which are not complicated by scarring caused by recurrent infection or tearing and
*where there are no personal, cultural or religious reasons mandating circumcision as the preferred manner of relieving a phimotic stenosis of the foreskin.References
External links
* [http://www.cirp.org/library/treatment/phimosis/saxena1 Circumcision Information and Resource page on Non-retractile foreskin]
* [http://www.rcsed.ac.uk/journal/vol44_5/4450008.htm Surgical technique]
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