Longer length improvement and more covert incision: a single-center, prospective study of two innovative surgical methods “one stitch” and “four stitch” for pediatric buried penis

Background To introduce the detailed procedures of two innovative surgical options for pediatric buried penis and prospectively compare their efficacy and safety. Methods A single-center, non-randomized, prospective study was conducted at the Zhongnan Hospital of Wuhan University, where patients were operated on using the so-called “one stitch” (OS) or “four stitch” (FS) methods. The operation time, adverse events, and satisfaction were recorded for both groups. Results Finally, 156 patients underwent the so-called OS ( n = 65) or FS ( n = 91) method, with a follow-up rate of 86.5% (135/156). During the perioperative period, the FS group spent much longer in surgery ( P < 0.001), had more blood loss ( P < 0.001), and took longer to recover from edema ( P < 0.001) than the OS group. In contrast to the satisfaction after 12 months’ follow up, both the objective length improvement (2.5 ± 0.6 vs 3.8 ± 0.5 cm, P < 0.001) and subjective satisfaction percent (86 vs 95%, P = 0.678) in the FS group were superior to those in the OS group. No significant differences were detected in postoperative infection, stenosis circle, scar hyperplasia, and relapse. Conclusions In conclusion, the two surgical options for pediatric buried penis are both safe and effective. The OS method has a simple procedure, so with shorter operation time and faster postoperative recovery; though the FS method with more complex procedure, patients can acquire a satisfactory improvement of penile length almost 4 cm and more covert incision at the midline of the scrotum. We primarily recommend the FS method for patients with moderate or severe buried cases; but for mild cases, we preferred the OS method.