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Circumcising Incision: Surgical Approach to the Penile Shaft

Urologic Indications for a Circumcising Incision

Circumcising incision is done for a surgical approach to the penile shaft:

Supine position.

Do a circumferential incision along the coronal sulcus. In circumcised patients, incise along the circumcision scar.
The skin of the penile shaft is pulled back and mobilized (degloving) on the level of the Buck fascia.
In uncircumcised patients, the inner layer of the prepuce is resected analogous to a circumcision.
Split the Buck fascia at 3 and 9 o'clock to isolate the neurovascular bundle. Mobilize the neurovascular bundle directly on the level of the tunica albuginea. A vessel loop is used for handling of the mobilized neurovascular bundle.

Cutaneous closure with interrupted sutures is analogous to circumcision. Use 4-0 or 5-0 quickly absorbable suture material.

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

J. A. Smith, S. S. Howards, G. M. Preminger, and R. R. Dmochowski, Hinman’s Atlas of Urologic Surgery Revised Reprint. Elsevier, 2019.