Modified versus traditional Devine procedure for pediatric concealed penis: a systematic review and meta-analysis<sup>#</sup>
Bibliographic record
Abstract
BACKGROUND: Concealed penis (CP) is a common congenital condition in pediatric urology, and surgical correction remains the mainstay of treatment. The modified Devine procedure (MDP) has been increasingly used, but its comparative safety and effectiveness relative to the traditional Devine procedure (TDP) remain unclear. This study aimed to compare the safety and effectiveness of the MDP with the TDP for the treatment of pediatric CP. METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 and AMSTAR guidelines. Prospective, retrospective, and randomized controlled studies comparing MDP and TDP for pediatric CP were included. Five databases (China National Knowledge Infrastructure, Medline, PubMed, Cochrane Library, and Web of Science) were searched from their inception to May 2025. Data extraction was performed independently by two authors, and discrepancies were resolved by a third reviewer. Statistical analyses were performed using Stata 16.0 software. Weighted mean difference (WMD) and odds ratio (OR) with 95% confidence intervals (CI) were calculated. Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and ROBINS-I tool. RESULTS: Twenty-two studies describing 1512 patients were included. Compared to the TDP, the MDP had an advantage in length of stay (weighted mean difference [WMD] = -1.19, 95% CI [-1.03, -0.15], p < 0.01), estimated blood loss (WMD = -4.32, 95% CI [-7.64, -1.01], p < 0.05), prepuce oedema time (WMD = -1.37, 95% CI [-2.49, -0.25], p < 0.05), postoperative penis length (WMD = 0.52, 95% CI [0.25, 0.80], p < 0.01), postoperative penis extension length (WMD = 0.90, 95% CI [0.58, 1.22], p < 0.01), complications (odds ratio [OR] = 0.15, 95% CI [0.10, 0.24), p < 0.01), prepuce oedema (OR = 0.21, 95% CI [0.13, 0.34], p < 0.01), penile retraction (OR = 0.21, 95% CI [0.06, 0.79], p < 0.05), postoperative pain (OR = 0.18, 95% CI [0.05, 0.64], p < 0.01), satisfaction (OR = 8.35, 95% CI [2.42, 28.78], p < 0.01), and effectiveness (OR = 4.64, 95% CI [2.61, 8.26], p < 0.01). The two surgical groups were comparable in terms of operative time. Several included studies had small sample sizes, and EMBASE was initially not searched due to institutional access restrictions, which may have led to the omission of relevant studies. CONCLUSION: Modified Devine procedure is superior to the traditional Devine procedure in the treatment of pediatric concealed penis. However, these results should be interpreted as preliminary trends, and further randomized controlled trials with larger sample sizes are needed to validate and strengthen these observations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.030 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".