What is megaprepuce repair?

Megaprepuce repair is a surgical procedure designed to correct a condition called megaprepuce. Megaprepuce is a rare congenital abnormality that affects some boys. It occurs when there is an excessive amount of foreskin, the skin that covers the tip of the penis, making it difficult to retract the foreskin and expose the head of the penis.

In boys with megaprepuce, the excess foreskin can cause problems with urination, hygiene, and sexual function later in life. The condition may also lead to discomfort or pain. To address these concerns and ensure proper development and function of the penis, megaprepuce repair surgery is performed.

When is megaprepuce repair indicated?

Megaprepuce repair is indicated in cases where a child is diagnosed with megaprepuce, a congenital abnormality characterised by an excessive redundant foreskin that covers the glans penis. The procedure is recommended when the condition causes functional issues, discomfort, pain, or potential complications related to urination, hygiene, or sexual function.

Here are some common indications for megaprepuce repair:

• Difficulty in retracting the foreskin: If the excess foreskin makes it challenging or impossible to retract the foreskin and expose the head of the penis, it can lead to hygiene difficulties and potential complications.
• Urinary problems: Megaprepuce may cause issues with urination, such as obstructed or weak urine flow, recurrent urinary tract infections, or urinary retention. These problems may require surgical intervention to improve urinary function.
• Pain or discomfort: In some cases, megaprepuce can cause discomfort or pain in the affected child, particularly during urination, erection, or sexual activity. Surgical correction can alleviate these symptoms and improve overall comfort.
• Hygiene difficulties: Excessive foreskin can make it challenging to maintain proper hygiene, leading to an increased risk of infections, inflammation, or unpleasant odours. Megaprepuce repair surgery aims to improve hygiene by allowing easier cleaning of the penis.
• Future sexual function concerns: If left untreated, megaprepuce may affect sexual function and intimacy later in life. Surgery can help ensure normal sexual development and function as the child grows older.

It's important to note that the decision to proceed with megaprepuce repair is typically made in consultation with a healthcare professional, such as a urologist or paediatric surgeon. They will assess the severity of the condition, evaluate the potential risks and benefits of surgery, and provide guidance tailored to the specific needs of the child. Parents or caregivers should seek medical advice if they suspect their child may have megaprepuce or have concerns about their child's penile development or function.

How is megaprepuce repair performed?

Megaprepuce repair is performed by a urologist or paediatric surgeon specialising in paediatric urological procedures. The surgery begins with the administration of anaesthesia to ensure the child's comfort and pain-free experience. Once the child is under anaesthesia, the surgeon makes a careful incision to access the excessive foreskin. The amount of foreskin removed depends on the severity of the condition.

After trimming away the redundant foreskin, the surgeon reconstructs the penile skin, aiming to restore proper retraction and exposure of the glans penis. This involves suturing the remaining penile skin to achieve a balanced and functional outcome. The incision is then closed with dissolvable sutures or other appropriate closure techniques, and a dressing or protective covering is applied to aid healing and protect the incision site.

Following the surgery, the child is monitored in a recovery area until they wake up from anaesthesia. The healthcare team provides detailed post-operative care instructions, including wound care, pain management, and activity restrictions. The child will need a few weeks to recover, and regular follow-up appointments are scheduled to monitor healing progress and ensure the child's well-being.