Preputioplasty

Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a minor plastic surgical operation on the prepuce or foreskin of the penis to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a stenosis which either has not relaxed during childhood and adolescence or has re-narrowed after sexual maturity.

Preputioplasty is a treatment for phimosis in the alternative to circumcision and superincision or dorsal slit which is which without
 * conservative,
 * non-traumatic,
 * less invasive;
 * can be performed on an outpatient basis under local anaesthetic in a doctor's office and
 * has the advantage of healing very quickly
 * any or any significant cosmetic alteration to the appearance of the penis.

Methods of performing preputioplasty
Preputioplasty may be performed by Y-plasty or Z-plasty, techniques also used in reconstructive surgery to loosen constricting scar tissue following traumatic burns.

However, Y-plasty and Z-plasty require a degree of surgical sophistication that physicians in general practice may lack.

More commonly it simply consists of one or more very short longitudinal incisions which release the stenosis — the constricting ring of tissue — in the foreskin and are closed transversely: [|] is closed and sutured as [—].

Comparison with dorsal slit
By contrast, the dorsal slit (sometimes referred to in anthropological literature as superincision) leaves the glans penis wholly exposed and the appearance of a circumcised penis from the dorsal aspect. However, no tissue is removed; the entire tissue of the foreskin gathers after a dorsal slit on the underside of the shaft, and gives the appearance of a turkey neck from a lateral or anterior view or in erection.

Preputioplasty versus circumcision and dorsal slit
European physicians and surgeons have carried out preputioplasties for many years in a social environment in which circumcision is widely considered anomalous.

Preputioplasty is appropriate in the majority of cases of non-retractile foreskin
 * which are not complicated by scarring caused by recurrent infection or tearing and
 * where there are no religious, cultural or other personal reasons mandating circumcision as the preferred manner of relieving a phimotic stenosis of the foreskin.