The outcomes of surgical management options for adult acquired buried penis

Abstract

The available studies that provide a detailed analysis of functional and surgical outcomes after surgical correction of adult acquired buried penis(AABP) are limited. 28 patients who underwent surgical treatment of AABP from 2017 to 2021 were retrospectively recruited. AABP repairs were classi ed according to surgical complexity following Santucci's classi cation. The primary endpoint of the study was the recurrence-free rate(RFR) survival. The secondary endpoints were surgical, functional and patients' reported outcomes(PROs). The most common complains at presentation were sexual(54%) and voiding(39%) dysfunction. 79% underwent a complex repair(≥III). Surgical management steps ranged from circumcision to more complex procedures, such as abdominoplasty(71%). When skin grafting was needed, a split thickness(25%) or full thickness skin graft(28.6%) was applied. Overall postoperative complications were recorded in 32.1%. High-grade complications(Clavien ≥3) occurred in 7.1%, all in high-complexity group. 1-year RFR survival was 88.7%. 57% answered the questionnaires. IPSS showed an improvement in urinary functon(pre=8(0-12) vs post=2(0-3)) and IIEF-15 in sexual functon(pre=37(23-68) vs post=68(45-72)) in postoperative settings. Overall, patients reported functional improvement and 93.5% were fully satis ed of the outcomes. QoL improved in 93.8% after the operation. Surgical management of AAPB, despite the high incidence of complications, guarantees satisfactory outcomes leading to a signi cant improvement in patients' QoL.

Lymphatic Mapping in the Repair of Adult-acquired Buried Penis: Proof of Concept

“…Adult-acquired buried penis (AABP) is an acquired clinical entity where a normal sized phallus is concealed by prepubic skin, fat, or subcutaneous tissue. 1 The main risk factor for developing AABP is obesity, with other etiologies, including genital lymphedema, hidradenitis and trauma. 2 The incidence of AABP, though incompletely understood, is thought to follow the rising trends of obesity, which has been increasingly seen by reconstructive urologists.…”

“… 2 Despite overall success, patients can experience bothersome genital lymphedema with rates ranging from 7.1% to 60%, based on a contemporary review of the literature. 1 …”

“…2 Despite overall success, patients can experience bothersome genital lymphedema with rates ranging from 7.1% to 60%, based on a contemporary review of the literature. 1 Lymphatic drainage from the scrotum, perineum, escutcheon, and skin of the penis drain into the superficial inguinal lymph nodes. 5 Little is known, however, about the exact disruption of lymphatic drainage in AABP.…”