Webbed Penis in Infants
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.
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.
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