What is Dorsal Slit?
A dorsal slit which is referred as superincision in anthropological literature is a procedure which leaves the penis completely exposed giving the appearance of a circumcised penis from the dorsal aspect. No tissue is removed from this procedure. The whole tissue of the foreskin collects after a dorsal slit found underneath the shaft. This gives the look of a turkey neck from a lateral or anterior view or during erection.
Effects of Dorsal Slit
Candidates for Dorsal Slit
Ideal candidates for this procedure are patients with symptomatic phimosis (balanitis, paraphimosis) as a first stage procedure. It can also be done when urethral instrumentation is necessary but cannot be done because of the phimosis.
Before undergoing the procedure, cleansing of the genitalia is done with the use of Betadine in saline solution. A 1% Xylocaine solution is then infiltrated for about 1 cm width at the selected area at the dorsal side of the penis near the constricting band.
The Dorsal Slit Procedure
The dorsal slit procedure is very simple and is a minimally invasive procedure. This is done with the foreskin being pulled down and held under a slight tension. The dorsal foreskin, at the 12 o’clock position, is then double clamped. Incision of the crushed tissue is then made. In order to avoid edema, adhesions, and sometimes paraphimosis, the amount of tissue left underneath the coronal sulcus should not exceed 1 cm long. The edges are approximated with the use of absorbable sutures.
It usually takes about 7-10 days before healing process takes place. At first, the tip of the penis will appear bright red. As healing comes about, the redness starts to fade and the penis will get back its normal skin color from tip to base.
When a dorsal slit is done on a young patient, the separate flaps of foreskin is likely, upon healing, to more or less disappear behind and underneath the glans. So even if it is obviously still there, the residual foreskin is out of the way and not noticeable. The remaining foreskin totally disappears during erection so the penis appears alike to one that was circumcised.
What benefits can one get from this procedure?
Phimosis is actually an unclear term. Commonly, this term is used to refer to any condition wherein the foreskin cannot be retracted due to severe tightness. True phimosis on the other hand should be recognized from a “normal” tight foreskin. Phimosis contains a thin band or ring of connective tissue that is embedded towards the front of the foreskin. This ring, which is often whitish, makes the opening narrow making it impossible to retract the foreskin. This leads to the tip of the foreskin losing its normal suppleness and becomes scarred.