Webbed Penis in Infants



Last updated: 01 March 2014, 16:11 UTC



What is Webbed Penis?

The condition is a minor congenital abnormality. Instead of the ventral aspect (the underneath) of the penis having a clearly defined seam (the raphe) along its whole length, a web of tissue exists linking the penis to the scrotum. Sometimes called a "Turkey Neck", this web of tissue is, in effect, a malformation of the raphe. Misplaced Dartos tissue may also be involved.


Treatment

The remedy is a surgical intervention called z-plasty, illustrated in an adult here. In cases where an unambiguously male child needs surgery to correct a congenital abnormality, it is generally preferable for the procedure to be done no later than 18 months of age. Then the boy grows up with no memory of his pre-repair condition or of the healing period. However, in the case of webbed penis this may not always be possible; the penis may not at that age be sufficiently developed for a z-plasty to be effective. On the other hand, correction as early as 6 months of age may be possible. This is very much a situation where each case needs judging on its individual merits, with the aim of striking a balance between conflicting surgical and psychological objectives and constraints.


Implications regarding circumcision

Infant circumcision is contra-indicated in cases such as the one illustrated because it may lead to the penis becoming trapped behind a tent-like fold of skin. Unlike - for example - the corrective surgery relating to hypospadias, there is no requirement for donor tissue in a z-plasty and so the procedure does not of itself include circumcision. But until the z-plasty has been performed, any circumcision is risky. Thus, despite the minor nature of the defect, a webbed penis may imply a need for long-term deferral of elective circumcision. Parents/guardians of a child with significant penile webbing may need to think in terms of pre-pubertal circumcision, not RIC. Religious or cultural norms should not be allowed to over-ride the best interests of the individual boy.


Acknowledgements

The following resources were used in the preparation of this web page:
USA flag (1336 bytes)   Stanford School of Medicine logo (2730 bytes)     Website of Stanford School of Medicine.
USA flag (1336 bytes)   Urology for Children logo (9656 bytes)     Website of Urology for Children LLC.





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