How do I do it: Modified Devine procedure with sleeve dartos fasciectomy for post-circumcision concealed penis.

Concealed penis after circumcision can result in a buried penis appearance due to fibrotic dartos tissue tethering the shaft. We present a modified Devine's procedure that includes complete circumferential excision of the abnormal dartos fascia ("sleeve" dartos fasciectomy) and dermal anchoring of the shaft skin to fully release the penis and improve exposure. In 22 boys treated with this technique, stretched penile length approximately doubled (from ∼1.8 cm to 4.3 cm) with no recurrences. Only minor complications occurred, and patient/family satisfaction with the postoperative appearance was high. This approach provides a simple, effective solution for post-circumcision concealed penis.