Current techniques in adult-acquired buried penis repair: where are we now

Abstract

Adult-acquired buried penis (AABP) is a condition associated with penile entrapment, penile shaft skin loss, and an enlarged pannus which engulfs the penis. The increased prevalence, awareness, and availability of surgical repair have led to a relative standardization in repairs. The surgical approach to AABP has evolved from a lengthy procedure with extended inpatient stay to one that may be done in an outpatient setting. The critical steps for surgical management of AABP have remained largely consistent over time, including: release of the penis with removal of diseased skin, suprapubic and/or abdominal panniculectomy, and skin coverage (usually with grafts). In contrast, the finer points of the procedure and perioperative care have undergone evolution. The aim of our approach was to optimize postoperative aesthetic and functional outcomes. Our perioperative management was modeled after enhanced recovery after surgery principles to minimize morbidity and expedite recovery. There remains room for improvement in the care of individuals with AABP, specifically multi-institutional collaboration, development of disease-specific outcome measures, and standardization of treatment algorithms.