V10-04 A BUCCAL MUCOSAL GRAFT SUB-CORONAL RESURFACING FOR TREATMENT OF RECURRENT PENILE ADHESIONS: THE BUCCAL BELT

Abstract

You have accessJournal of UrologyLower Tract Reconstruction (V10)1 Sep 2021V10-04 A BUCCAL MUCOSAL GRAFT SUB-CORONAL RESURFACING FOR TREATMENT OF RECURRENT PENILE ADHESIONS: THE BUCCAL BELT Matthew Beamer, Javier Angulo, Leandro Capiel, Damian López-Alvarado, Erick Ramirez-Perez, Paksi Satyagraha, Daniel Zaccarini, and Dmitriy Nikolavsky Matthew BeamerMatthew Beamer More articles by this author , Javier AnguloJavier Angulo More articles by this author , Leandro CapielLeandro Capiel More articles by this author , Damian López-AlvaradoDamian López-Alvarado More articles by this author , Erick Ramirez-PerezErick Ramirez-Perez More articles by this author , Paksi SatyagrahaPaksi Satyagraha More articles by this author , Daniel ZaccariniDaniel Zaccarini More articles by this author , and Dmitriy NikolavskyDmitriy Nikolavsky More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002061.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recurrent penile adhesions often cause pain, post-coital bleeding, disfigurement and patient distress. Treatment options are limited and include topical steroids, lysis of adhesions and repeat circumcisions. Furthermore, adhesions are often associated with Lichen Sclerosus (LS) limiting the use of skin in any reconstruction. We present a novel surgical procedure using a sub-coronal buccal mucosal graft (BMG) resurfacing technique. METHODS: To perform the buccal belt procedure a sub-coronal segment of affected skin, approximately 1.5 cm in width, was circumferential excised. The circumference of the penile shaft was measured and an appropriately size buccal mucosal graft was harvested. The graft was placed sub-coronally and secured circumferentially with a proximal and distal anastomosis. Buck’s fascia was included in both the anastomosis and quilting sutures to allow for appropriate spread fixation of the graft. A vaseline gauze bolster was secured as a tie-over dressing. Patients were discharged with the bolster dressing and foley catheter. They were seen 7 days postoperatively for removal and then at 4-6 month intervals for follow-up. A retrospective, international multi-institutional review was conducted to include all patients treated with this technique. Surgical complications and evidence of recurrence were recorded. Patient-reported outcome measures including visual analog scale (VAS) and Global Response Assessment (GRA) questionnaires administered to measure functional and esthetic outcomes were also reviewed. RESULTS: Thirty-one men underwent the procedure across six institutions between 3/2014 and 9/2020. Mean age was 56.3 (32-77) and prior treatments included: topical agents 14 (45%) and circumcision 25 (81%). LS was seen in 23(74%) patients. Mean surgical time was 59 (25-95) minutes and mean hospital stay was 0.65(0-2) days. At the mean follow-up of 27 (4-79) months no patients developed recurrence. No patients reported painful erections. Mean VAS was 8.9 and 9.0 for esthetics and functional outcomes respectively. On GRA overall improvement was reported by all patients (61% +3; 25% +2; 14% +1). The majority saw improvement in esthetic appearance (46% +3; 39% +2; 7% +1; 4% 0; 4% -1) and improvement with post-coital bleeding (43% +3; 43% +2; 4% +1; 11% 0). Ninety-six percent would recommend the procedure to a friend. CONCLUSIONS: There are limited options for the treatment of recurrent penile adhesions, particularly in the setting of LS. A sub-coronal BMG resurfacing is feasible, with no recurrence and overall high satisfaction seen on an initial patient cohort. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e756-e756 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Beamer More articles by this author Javier Angulo More articles by this author Leandro Capiel More articles by this author Damian López-Alvarado More articles by this author Erick Ramirez-Perez More articles by this author Paksi Satyagraha More articles by this author Daniel Zaccarini More articles by this author Dmitriy Nikolavsky More articles by this author Expand All Advertisement Loading ...