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Buried penis: a histological and histochemical study of dartos fascia

Zhang, Hong-Yi1,2; Zhao, Gang-Gang1,2; Song, Yi-Ting1,2; Xiao, Ke-Bing1,2; Li, Hua-Feng1,2; Cui, Jie2

1Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an 710000, China

2School of General Medicine of Xi’an Medical University, Xi’an 710000, China

Correspondence: Dr. J Cui (cuicui780204@163.com)

Originally published: March 14, 2023 Received: May 12, 2022 Accepted: January 15, 2023


This study aimed to determine whether the abnormal deep layer of dartos fascia plays an important role in buried penis. Forty-nine patients with buried penis were treated with anatomical resection of the deep layer of dartos fascia under a microscope. Penile length was measured before and after completely resecting the deep layer to investigate the role of this layer in penile retraction. The superficial and deep layers of dartos fascia were collected from 49 patients with buried penis, the normal superficial layers were collected from 25 children/adults who underwent circumcision for nonmedical reasons, and the normal deep layers were collected from 20 adult cadavers. The penile fascia samples were stained with hematoxylin-eosin, Masson’s trichrome, Sirius red, and Verhoeff’s Van Gieson, and subjected to immunohistochemical examination and scanning electron microscopy. The penile shaft (mean ± standard deviation) was found to be significantly elongated after resecting the deep layer compared with that before resection (6.8 ± 1.9 cm vs 6.0 ± 1.6 cm, P < 0.001). An abnormal deep layer of dartos fascia characterized by disordered and fragmented elastic fibers was observed in 87.8% (43/49) of buried penis samples, whereas no abnormal deep layer was observed in normal penises from cadavers (0/20, P < 0.001). Thus, the abnormal deep layer of dartos fascia plays an important role in the buried penis. Its resection is helpful for avoiding recurrence.

Keywords: buried penis; dartos fascia; recurrence; surgery

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.