Is the simple webbed penis a contraindication to circumcision?

Abstract

Background: Surgical correction of the webbed penis is challenging. We presented the safety and feasibility of webbed penis correction for neonates under local anesthesia using a simple principle of leaving equal cylindrical shaft skin. Methods: This retrospective study included 530 patients who presented for circumcision to three pediatric surgery centers between May 2017 and January 2020. We included male patients aged less than four weeks old who had circumcision with a minimum of 6 months follow-up. We compared patients with normal penile anatomy (n = 451, Group 1) to a simple webbed penis (n = 79, Group 2). Results: There were no differences in age and weight between groups. The procedure time was significantly longer in Group 2 (8.05 ± 3.11 vs. 7.48 ± 2.07 min; P = 0.04). There were no differences in bleeding (P = 0.38), redundant foreskin (P > 0.99), need for corrective surgery (P = 0.38), and re-suturing (P = 0.28) between groups. The procedure success was significantly higher in Group 1 (449 (99.56%) vs. 70 (88.6%); P < 0.001). Parents' satisfaction was measured at two weeks with no difference between both groups. Conclusion: Simple penoscrotal web is not a contraindication for neonatal circumcision. Circumcision of the penoscrotal web had good esthetic results with comparable outcomes to those with a normal penis without a web.