From ballooning to normal voiding: functional and cosmetic outcomes after congenital megaprepuce repair: a case report

Abstract

Congenital megaprepuce (CMP) is a rare congenital disorder characterized by excess mucosa accompanied by a partial thickening of the ventral prepuce. This abnormality causes complete penis coverage without any additional penile abnormalities, leading to ballooning of the prepuce due to urinary retention, which is the primary complaint of patients. We report a 4-year-old boy who came to the urology clinic with complaint of difficult micturition, pain, and ballooning of the prepuce during urination. The ballooning was from the accumulation of urine in the preputium. It happened since the patient was an infant. The patient sometimes felt a fever every single month but was getting better after taking medication. Local examination of genitalia showed the penis appeared buried beneath a large amount of skin of preputium, which was excessively redundant and also not circumcised yet. During micturition, urine collects within this sac, leading to ballooning of the prepuce, and urine dribbling through the small prepuce orifice. The patient was planning for surgical intervention to release the glans penis with circumcision and reconstruction of the penis. Congenital megaprepuce (CMP) needs to be differentiated from other penile anomalies such as buried penis and webbed penis. Early recognition and surgical intervention are essential to prevent complications and achieve satisfactory cosmetic outcomes for the circumcised penis.

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