Management of adult concealed penis using a meshed, split-thickness skin graft

Boonjindasup, Aaron; Pinsky, Michael R.; Stewart, Carrie; Trost, Landon; Chaffin, Abigail E.; Jansen, David

doi:10.5489/cuaj.3787

Cited by 13 publications

(8 citation statements)

References 13 publications

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“…An early series in the plastic surgery literature utilized full thickness skin grafts from the abdominal pannus [10] . However, split-thickness skin grafts have become the modality of choice in the urologic literature [5,6,13,16,17,[19][20][21][22] . Split-thickness skin grafts have the advantage of maximizing graft take rates, while being universally available (usually from the thigh).…”

Section: Surgical Steps -Release Of the Buried Penismentioning

confidence: 99%

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

Theisen¹,

Alford²,

Kim³

et al. 2020

PAR

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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.

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Section: Surgical Steps -Release Of the Buried Penismentioning

confidence: 99%

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

Theisen¹,

Alford²,

Kim³

et al. 2020

PAR

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“…The incidence of the CP has not been systematically studied, althougha Japanese study reported a prevalence of 3.7% in male newborn infants [5]. In addition to the abnormal appearance, CP might exert symptoms and negative psychological effects, such as anxiety and/or depression, on children and their parents [6].Spinoit et al [7] had observed abnormal histology of the dartos fascia in 74% of patients with CP and dartos layer of penises then became nonelastic which prevents forward extension of the penis and entrapped it under the pubis. The CP remained a challenge for urologists and a exible surgical approach might be required [2].…”

Section: Introductionmentioning

confidence: 99%

Assessment of The Nerve Ending Distributions on Dartos Fascia in Children with Concealed Penises

Huang¹,

Tang²,

Gu³

2020

Preprint

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Background: The role of nerve ending distribution indartos fascia in the pathogenesis of concealed penis (CP) is still unclear. Our aim is to compare the histological structure of dartos fascia of both normal and CP tissue to evaluate the importance of nerve ending distribution. Methods: After degloving, tissue specimens of dartos fascia located at 3-, 6-, 9-, and 12- o’clock of the penile shaft were harvested from the CP.Therelatively normal tissues at the periphery after resection of black moles or hemangioma in other parts were considered as control. The distribution of nerve plexuses between these groups was compared using standard hematoxylin and eosin (H&E) staining and S-100 immunohistochemical staining. Results: The number of nerve plexuses for all cases of CP was abundant but significantly fewer in the normal group. In CP, the number of nerve plexuses in superficial fascia collected at 6 o’clock position of penile shaft was the most abundant among different positions. Conclusions: Abundant nerve plexuses were presented indartos fascia in children with CP, especially at the 6 o’clock position,suggesting surgery performed at the preputial frenulum should avoid damage of dartos fascia to preserve the erectile and sexual function of penis in puberty.

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“…Anatomically it is described as when the penis is located beneath the abdomen, thigh or scrotum [ 1 , 2 ]. It is important to note that the penis has a normal corporal length, but poor phallic exposure, and so is distinguishable from conditions such as micropenis [ 3 ]. In cases of buried penis, the penile shaft lies ‘below the prepubic skin’ and is no longer visible due to complete burying.…”

Section: Introductionmentioning

confidence: 99%

“…Complex buried penis is used for cases in which there are multiple causative factors resulting in burial of the penis – for example, patients suffering from both obesity and lymphoedema. Inevitably these patients prove very difficult to treat, often requiring multiple surgeries, delayed healing and a longer time to achieve satisfactory postoperative results [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management of Buried Penis in Adults

Anandan

Mohammed

2018

Cent european J Uro

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IntroductionBuried penis is a condition that causes the penis to become hidden beneath the skin. It has a significant impact on quality of life and can present in a variety of ways, with lower urinary tract symptoms and erectile dysfunction being common. Whilst there are several causes, obesity is the most common in adults. Due to the burden that obesity is increasingly presenting to healthcare, buried penis may become more common in the future.The purpose of this article is to provide an overview of the causes, presentation and surgical management of this condition in adults.Material and methodA literature review was conducted using urological and plastic surgery articles from PubMed, Embase and Medline. Eighteen studies, published between 1982 and 2016, were included.ResultsOriginal research trials discussed the treatment of buried penis in lymphoedema and balanitis xerotica obliterans (BXO), new techniques for fat removal, comparison of grafts and postoperative dressings. Several studies provided broad overviews, although focused on management rather than cause and presentation. Overall, studies suggest that, whilst some causes can only be treated with surgery, others can be modified by lifestyle changes and medical management.ConclusionsBuried penis is a complex condition that may take years to treat. Several surgical techniques are available, with patients likely requiring a combination of techniques to treat this problem. This review aims to provide a comprehensive overview of the causes, presentation and surgical management of this condition, in order to further the understanding of clinicians who may be faced with this problem more commonly in the future.

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Management of adult concealed penis using a meshed, split-thickness skin graft

Cited by 13 publications

References 13 publications

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

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

Assessment of The Nerve Ending Distributions on Dartos Fascia in Children with Concealed Penises

Surgical Management of Buried Penis in Adults

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