Management of the Buried Penis in Adults

Abstract

With appropriate planning and adherence to basic reconstructive surgical principles, correction of the buried penis can yield a high success rate.

Treatment of Adult-Acquired Buried Penis

“…Urine is trapped and the cycle continues. Most patients are obese and have associated comorbidities such as diabetes mellitus, which may worsen the patient's prognosis (Donatucci & Ritter, 1998).…”

“…Frankl et al (2004) describes; in the pediatric population indications for surgery which include recurrent balanitis, secondary phimosis, difficulty holding the penis during voiding, urinary stream spraying, social embarrassment, and parent's concern for future social embarrassment (Frenkl et al, 2004). These are widely accepted (Adham et al, 2000, Alici et al, 1998, Chuang et al, 2001, Donatucci & Ritter, 1998, Frenkl et al, 2004. However, in dealing with the adult population, the primary indications are related to sexuality.…”

“…Buried penis was described as the "absence of the penis exists when the penis, lacking its proper sheath of skin, lies buried beneath the integument of the abdomen, thigh or scrotum (Keyes, 1919)." Classically, the entity of buried penis has been primarily discussed in the pediatric population (Boemers & De Jong, 1995, Crawford, 1977, Donatucci & Ritter, 1998, Lim et al, 1995, Maizels et al, 1986, McCahill et al, 1995, Wollin et al, 1990. However, a buried penis afflicts many adults leaving them with the inability to have sexual relations, practice personal hygiene, or stand to void since they are unable to direct their penis during micturition (Cromie et al, 1998).…”

“…However, a buried penis afflicts many adults leaving them with the inability to have sexual relations, practice personal hygiene, or stand to void since they are unable to direct their penis during micturition (Cromie et al, 1998). Unlike the pediatric patient population, adults with buried penis have acquired this condition as a result of obesity, over exuberant circumcision, scarring due to lichen sclerosis et atrophicus (previously as known as balanitis xerotica obliterans) or lymphedema (Alici et al, 1998, Chopra et al, 2002, Donatucci & Ritter, 1998, Sivakumar et al, 2004, Tang et al, 2008. This chapter discusses the pathophysiology of a buried penis, patient selection for operative management, and surgical management with associated complications.…”

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

“…1 Ten years later, Pestana et al revisited the subject and provided a thorough overview of the literature and current techniques available for adult CP. 2 Higuchi et al made great strides in classifying the problem of CP and presented a well-organized updated treatment algorithm based on Donatucci and Pestana's earlier works.…”