What is the functional and cosmetic outcome of the ventral slit procedure for congenital megaprepuce?

Keywords: urology, genitourinary surgery, congenital megaprepuce, ventral slit procedure


Background: Congenital megaprepuce is a urological condition characterised by a megapreputial reservoir with a long redundant inner prepuce. An impeded urinary stream and resultant ballooning is associated with discomfort and causes parental anxiety due to the unusual appearance of the phallus. Surgical correction should improve functionality, but cosmesis is also important. This study took place in a community in which traditional circumcision remains an essential rite of passage. Therefore, early surgical correction of congenital megaprepuce was complicated by the unique requirement that patients remain uncircumcised. The aim of this study was to assess the functional and cosmetic outcome of the ventral slit procedure (an uncomplicate technique used to restore urinary flow which, importantly, preserves the foreskin), as reported by the parents of the patients.

Methods: Here we investigated the functional and cosmetic outcomes of the ventral slit procedure, in a retrospective review of patients operated on between 2014 and 2018 in our hospital – Red Cross War Memorial Children’s Hospital. Twenty-five cases were identified, of which only 18 patients were contactable telephonically. Parents of 18 paediatric patients were interviewed postoperatively in a telephonic survey regarding phallic appearance and functionality following surgery.

Results: Overall, the ventral slit procedure successfully restored flow, prevented ballooning and alleviate discomfort during voiding in all 18 patients. Parents interviewed were highly satisfied with surgical outcomes, as assessed by the paediatric penile perception score.

Conclusion: The ventral slit procedure was found to be a culturally acceptable and simple surgical solution to congenital megaprepuce.

Author Biographies

D B Tasker, Limpopo University

Division of Paediatric Surgery, Department of Surgery, Mankweng and Polokwane Hospitals Tertiary Academic Complex, University of Limpopo, South Africa

J Howlett, University of Cape Town

Division of Urology, Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa

H Rode, University of Cape Town

Department of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

How to Cite
Tasker, D., Howlett, J., & Rode, H. (2022). What is the functional and cosmetic outcome of the ventral slit procedure for congenital megaprepuce?. South African Journal of Surgery, 60(3), S13-S17. Retrieved from http://sajs.redbricklibrary.co.za/index.php/sajs/article/view/3908
Paediatric Surgical Special Edition