Redundant Prepuce

Overview

What is a redundant prepuce?

The skin on the head of a penis is called the foreskin. Another name for foreskin is prepuce. A redundant prepuce means that there is an excess amount of foreskin – the foreskin completely covers the head of the penis when it is not erect. In some boys and men, this extra foreskin can sometimes lead to health problems if it can’t be fully drawn back from the head of the penis. In this case, the foreskin may need to be surgically removed.

What role does circumcision play?

Getting circumcised (surgical removal of the foreskin) is a procedure decided by the parents of a newborn son, or by the son himself if older. Circumcision can be a controversial procedure for some. The decision for circumcision or revision is best made by parents and/or male after a conversation with the surgeon.

Most male babies in the United States and the Middle East are circumcised (rates are much lower in Latin America, Europe, and Asia). Most of these procedures are done correctly. However, sometimes not enough of the foreskin is removed. When this happens, your child’s penis will look unusual since it is not fully circumcised or uncircumcised. You (the parents) or son (if older) may choose to have a second circumcision either to improve the appearance of the penis or to avoid (or lower the risk) of some of the problems that can occur in uncircumcised males. These problems include:

  • A buildup of smegma (the substance that helps lubricate the penis).
  • Inflammation of the head of the penis and foreskin.
  • Infections, including urinary tract infections and sexually transmitted infections.
  • Penile cancer.

What does a second circumcision involve?

Having a second circumcision is often called “circumcision revision.” It is uncommon but sometimes necessary.

Studies show that if a child has too much foreskin after a first circumcision, it is best not to wait too long to correct it. The problem typically will only get worse if not treated. Boys do not “grow into” a longer-than-usual foreskin.

Management and Treatment

Who performs circumcision revision?

Circumcision revision is most often done by a urologist (doctor who specializes in treating male reproductive organs) in a hospital. General anesthesia is usually needed.

How is circumcision revision done?

The sleeve surgical technique, in which the foreskin is removed from its pulled-back position, is most commonly used when males have too much foreskin. Other techniques may be used depending on the reason for the revision and the boy’s/man’s age. A urologist will be able to decide the type of revision that is best.

Outlook / Prognosis

What is the prognosis for males who have circumcision revision?

Circumcision revision usually is very successful. Your son’s urologist can review the benefits your son can expect to receive.

What care is needed after the circumcision revision?

The line of absorbable stitches (stitches that don’t need to be removed) is covered with an antibiotic ointment and covered with a sterile dressing. The dressing is usually left on for 24 to 48 hours. After that time, the dressing is removed and antibiotic ointment is continued to be used for the first seven to 10 days to prevent the stitches from sticking to diapers or underwear.

Last reviewed by a Cleveland Clinic medical professional on 12/08/2020.

References

  • Brisson PA. Patel HI, Feins NR. J Pediatr Surg 2002 Sep;37(9):1343-1346. Accessed 12/8/2020.Revision of circumcision in children: Report of 56 cases. (https://pubmed.ncbi.nlm.nih.gov/12194129/)
  • American Urological Association. Urology Care Foundation. . Accessed 12/8/2020.Circumcision: What parents should know (http://www.urologyhealth.org/patient-magazine/magazine-archives/2013/spring-2013/circumcision)
  • American Psychological Association. Dictionary of Psychology. Accessed 12/8/2020.Redundant prepuce. (https://dictionary.apa.org/redundant-prepuce)
  • American Academy of Pediatrics Task Force on Circumcision. Task Force on Circumcision. Male Circumcision. J Pediatr 2012 Sep; 130(3):e756-e785. Accessed 12/8/2020.
  • Arkovitz MS. Arkovitz M.S. Arkovitz, Marc S.Circumcision. In: Ziegler MM, Azizkhan RG, Allmen D, Weber TR. Ziegler M.M., & Azizkhan R.G., & Allmen D, & Weber T.R.(Eds.),Eds. Moritz M. Ziegler, et al.eds. Operative Pediatric Surgery, 2e. McGraw-Hill; Accessed 12/8/2020.
  • Mu J, Fan L, Liu, D, Zhu D. . Urology J 2020;17(3), 301-305. Accessed 12/8/2020.A Comparative Study on the Efficacy of Four Types of Circumcision for Elderly Males with Redundant Prepuce (https://doi.org/10.22037/uj.v0i0.4973)

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