The morphological features of the penile raphe and its clinical application in the circumcision using the disposable circumcision suture device

Abstract

Abstract OBJECTIVESto describe the morphological feature of the penile raphe, to solve the frenulum malposition based on the morphological classification of penile raphe in circumcision with the disposable circumcision suture deviceMethodsFrom November 2013 to April 2021, there were 2265 consecutive Chinese patients who underwent circumcision in our hospital. Each patient’s penile raphe morphological feature was recorded and grouped. It could be categorized four type of raphe feature : typeⅠ, the middle raphe; typeⅡ,the middle double raphe or middle band; type Ⅲ, the diamond or lozenge-shaped raphe; type Ⅳ, marked by some hyperpigmentation zone. The case of distinctive type of the penile raphe was treated with different strategy to guarantee the frenum matching. The convexity frenulum cutting site (CFCS) which could be palpated as small rounded eminence tissue at the ventral prepuce during the procedure was also used as an assisting anatomy marker. Other data recorded including operation time, type of anesthesia, intra-operative blood loss, incision healing time, complications and patient satisfactory.RESULTSAccording to the classification system there were 842 (37.2%) cases in type Ⅰ; 258 (11.4%) cases in type Ⅱ; 992 (43.8%) cases in type Ⅲ and 173 (7.6%) cases in type Ⅳ. Following the treatment principle based on the penile raphe feature, no case of notorious frenulum deviation was observed after the 16 cases of frenulum malposition recounted in the first 100 cases in our series. The overall satisfactory rate was high (2185, 93.9%).ConclusionsThe morphological classification of the penile raphe incombinating with the anatomy marker of CFCS will facilitate accurate identification of the frenulum location, better located its right position and cosmetic outcome.