Preputioplasty

Preputioplasty or prepuce plasty, also known as limited dorsal slit with transverse closure, is a plastic surgical operation on the prepuce or foreskin of the penis,[1] to widen a narrow non-retractile foreskin which cannot comfortably be drawn back off the head of the penis in erection because of a constriction (stenosis) which has not expanded after adolescence.

Preputioplasty is a treatment for phimosis in the alternative to circumcision and radical dorsal slit Preputioplasty may be performed by Z-plasty, 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.

In the alternative to suturing, "[h]aemostasis [has been successfully] performed [in children] with a heated probe using the flame of an alcohol lamp or with bipolar electrodiathermy.

If incisions are placed on the sides of the phimotic ring, the ultimate cosmetic result is better.

Preputioplasty
Fig 1. Penis with tight phimotic ring making it difficult to retract the foreskin.
Fig 2. Foreskin retracted under anaesthetic with the phimotic ring or stenosis constricting the shaft of the penis and creating a "waist".
Fig 3. Incision closed laterally.
Fig 4. Penis with the loosened foreskin replaced over the glans.