Surgical Correction Of Buried Penis Research Articles

Surgical correction of buried penis with a skin graft: case report

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

PT259 - Simple anchoring method in surgical correction of buried penis

PT259 - Simple anchoring method in surgical correction of buried penis

Early surgical correction of buried penis

Introduction: Buried penis is a developmental condition characterized by normal size penis that appears smaller or hidden by suprapubic fat. Many complications are associated with buried penis, including poor cosmoses, poor hygiene, difficult accessibility, and recurrent balanitis. Urinary tract infection, negative feeling by parents and patients. Different surgical techniques have been described to correct the condition. Aim: The aim of this study was to present our result of early surgical correction of buried penis. Results: A total of 94 patients underwent correction of buried penis. 80 (85%) patients were less than 2 years of age. The mean follow-up was 8 months, ranging from 6 to 22 months. The most common types of anomaly were buried penis [65 (59.5%)], concealed penis [21 (22.3%)], and trapped penis [eight (8.5%)]. The early postoperative complications were edema [10 (10.6%)], bleeding [four (4.2%)], excess inner prepuce [three (3.1%)], redundant skin [two (2.1%)], and infection [one (1.06%)]. The late postoperative complications were partial recurrence in 6.3%. In 63.8% the skin was adequate and there was no need for additional skin flap; in 27.6% we created payers flap and in 8.5% we used the long inner prepuce. Conclusion: Early surgical correction of buried penis is safe and is associated with minimal complications. Keywords: buired penis, circumcision, trapped penis

Surgical and Functional Outcomes Following Buried Penis Repair With Limited Panniculectomy and Split-thickness Skin Graft

To report surgical and functional outcomes of buried penis surgery. Outcomes following buried penis surgery at the University of Washington were assessed from June 1, 2005 to June 1, 2016. Patient demographic and surgical data were abstracted from a retrospective chart review. All patients were attempted to be contacted by phone for long-term follow-up. Uni- and multivariate analysis was performed to evaluate for association with any complication. A total of 42 men underwent buried penis repair surgery (mean short-term follow-up 8.1 months). There was an overall 33% 90-day complication rate (21 events). In univariate analysis, body mass index (BMI; P = .02) and no history of gastric bypass (P = .03) were significant predictors of any complication. In multivariate analysis, only BMI remained significant (odds ratio 1.1 for each increase in unit of BMI, 95% confidence interval 1.01-1.27). Twenty-seven patients were reached for long-term follow-up (mean 39 months). Patients reported improvements in every functional domain that was assessed. Of the patients, 85% reported they would undergo buried penis surgery again, 74% that surgery led to a positive change in their lives, and 85% that the surgery had remained a long-term success. Surgical correction of buried penis with penile split-thickness skin graft and limited panniculectomy is well tolerated and results in functional, long-term improvements. BMI is associated with an increased likelihood of a complication following surgery.

PD63-11 SURGICAL AND FUNCTIONAL OUTCOMES FOLLOWING ADULT BURIED PENIS REPAIR WITH LIMITED SUPRAPUBIC PANNICULECTOMY AND SPLIT-THICKNESS SKIN GRAFTING

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II1 Apr 2017PD63-11 SURGICAL AND FUNCTIONAL OUTCOMES FOLLOWING ADULT BURIED PENIS REPAIR WITH LIMITED SUPRAPUBIC PANNICULECTOMY AND SPLIT-THICKNESS SKIN GRAFTING Lindsay Hampson, Wade Muncey, C.C. Ma, Jeffrey Friedrich, Hunter Wessells, and Bryan Voelzke Lindsay HampsonLindsay Hampson More articles by this author , Wade MunceyWade Muncey More articles by this author , C.C. MaC.C. Ma More articles by this author , Jeffrey FriedrichJeffrey Friedrich More articles by this author , Hunter WessellsHunter Wessells More articles by this author , and Bryan VoelzkeBryan Voelzke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2935AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Adult buried penis is an acquired disorder that can result in secondary manifestations including phimosis, lichen sclerosis, lower urinary tract symptoms, and/or sexual dysfunction. Few published data exist regarding surgical repair, with no universally-accepted technique. We describe our technique for surgical management and report postsurgical clinical and functional outcomes. METHODS Patents at Harborview Medical Center were assessed between 6/1/2005 - 6/1/2016. Surgical reconstruction included limited suprapubic panniculectomy with pubic symphysis fixation, excision of penile shaft skin with split-thickness skin graft (STSG), and scrotoplasty if needed. Patient demographic and surgical data were abstracted via chart review. All patients were attempted to be contacted by phone for updated followup. Uni- and multi-variate analysis was examined for association with any complication (p < 0.05 considered significant). RESULTS 42 men underwent buried penis repair. Demographic and surgical characteristics by complication are shown (Table). There was a 33% complication rate (24 events), with the majority related to the pannus wound (8), genital wound (6), or graft loss (5). In univariate analysis, BMI (p = 0.02) and no history of gastric bypass (p = 0.03) were significant predictors of a complication. Upon multivariate analysis, only BMI remained significant (OR 1.1 for each unit increase of BMI, 95% CI 1.01 - 1.27). 24 patients were reached for long-term followup (mean 35.5 ± 36.7 months). There was long-term improvement in every functional domain that was assessed (Figure). 79% reported they would undergo buried penis surgery again, 68% reported that surgery led to a positive change in their lives, and 79% reported that the surgery had remained a long-term success. CONCLUSIONS Surgical correction of buried penis results in functional long-term improvements. Higher BMI is associated with an increased likelihood of a perioperative complication, and this risk may be reduced by preoperative weight loss following gastric bypass. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1258-e1259 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Lindsay Hampson More articles by this author Wade Muncey More articles by this author C.C. Ma More articles by this author Jeffrey Friedrich More articles by this author Hunter Wessells More articles by this author Bryan Voelzke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

A New Technique of Concealed Penis Repair

Phimosis associated with concealed penis is not amenable to ordinary circumcision. To our knowledge we describe a new technique to repair concealed penis. From September 2003 to January 2008, 57 consecutive patients with concealed penis were treated using our technique. Median age at surgery was 33 months (range 7 months to 34 years). The technique consists of 3 steps. Step 1 is a ventral incision to slit the narrow ring of the prepuce and expose the glans. Step 2 is a circumferential skin incision made between 2 edges of the ventral diamond-shaped skin defect, followed by midline incision of the dorsal inner prepuce to make 2 skin flaps connected to the glans. Step 3 is skin coverage. Two skin flaps are brought down and sutured together on the ventral side of the penis. The suture line between the penile shaft skin and the flap eventually becomes elliptical. Medical records were reviewed for voiding function, scar formation, and replies from older patients and the parents of younger children about impressions of the surgical results. Median followup was 26 months. No patient had voiding problems. Lymphedema persisted due to suture line constriction in 2 patients who underwent incision of the constriction. All older patients and the parents of younger children were satisfied with the surgical results. Our new method is easy to design and perform to correct concealed penis. It provides a good cosmetic appearance and seems to be applicable in all cases with deficient penile shaft skin.

Penoplasty for buried penis in infants and children: report of 100 cases

The aim of this study is to report single surgeon's experience in treatment of buried penis in children and describe the surgical technique which was developed by the senior author. Described surgical technique avoids circumferential incision at the base of the penis and thus prevents formation of post-operative lymphedema. Repair is based on a vertical incision in median raphe, complete degloving of penis and tacking its base to prepubic fascia. Shaft skin is attached to base of penis with vertical mattress sutures. Patient age varied from 1 month to 11.4 years (mean 1.9 years). All patients had good to excellent outcome with uniformly improved visualization of penile shaft post-operatively. There was one case of wound infection successfully treated with oral antibiotics. Revisions were needed in 4% patients. Surgical correction of buried penis in infants and children is safe and effective. Described technique is applicable for essentially all cases of congenital buried penis as well as for iatrogenically entrapped penis after circumcision. In our experience there were no additional procedures required to assure skin coverage of penile shaft.

Surgical correction of buried penis: A review of 60 cases

Background/Purpose: The authors reviewed 60 cases of buried penis, treated in a single institution with postoperative follow-up for at least 6 months. The review was aimed at providing information that might help to optimize the results in future surgical correction of this uncommon, but not rare, congenital disorder. Methods: From January 1, 1989 to December 31, 1998, 62 boys with buried penis were treated with 1 of the following procedures: group 1A (n = 6), preputial unfurling alone; group 1B (n = 8), modified preputial unfurling; group 1C (n = 12), penoplasty devised by the first author with preservation of the preputial skin; and group 2 (n = 36), penoplasty with trimming of the inner preputial skin. Postoperative follow-up of more than 6 months after operation was achieved in 60 of 62 patients for a total of 25 patients in group 1 (A through C) and 35 patients in group 2. Results: Recurrent buried penis developed in 8 of 60 patients (13%), and redundant penile skin with or without lymphedema occurred in 18 (30%). The complications occurred in 18 of 25 patients (72%) in group 1 (A through C) but in only 8 of 35 (23%) in group 2. The difference was significant (P =.001). Most of the complications were mild and acceptable. A second procedure was required in 5 of the 25 patients in group 1 but in none of group 2. The second procedures were required to correct recurrent buried penis in 1 and to resect excess redundant penile skin in 4. Conclusion: The superior results achieved in group 2 suggest that in addition to penoplasty with adequate fixation of the unfurling prepuce, resection of excess inner preputial skin is required to achieve an optimal outcome in children requiring surgical correction of buried penis. J Pediatr Surg 36:426-429. Copyright © 2001 by W.B. Saunders Company.

A NEW TECHNIQUE FOR CORRECTION OF THE HIDDEN PENIS IN CHILDREN AND ADULTS

A phenomenon known as hidden penis has numerous origins, including congenital buried penis and obesity with descent of the escutcheon. No previous report to our knowledge mentions abnormal hypermobility of ventral skin and dartos fascia, which is a major cause of surgical treatment failures. Because the skin and dartos fascia are inadequately attached to Buck's fascia, the corporeal bodies telescope proximally inside the scrotum and pubis. Therefore, the subdermis of the penoscrotal junction must also be tacked to the tunica albuginea ventrally to stabilize the proximal penile skin and prevent the penis from retracting into the scrotum. The surgical technique for correction of the hidden penis in adult and pediatric patients with adequate penile shaft skin is described. Surgery for hidden penis from multiple causes was performed in 6 adults and 7 children. Tacking sutures were taken from the subdermis of the ventral penoscrotal junction to the tunica albuginea in all cases. A combination procedure with either suprapubic dermatolipectomy, tacking of the penopubic subdermis to the rectus fascia, penoscrotal Z plasty, circumcision revision or lateral penile shaft Z plasty also was performed in some patients. Improvement was noted in all cases. One child requires suprapubic lipectomy for optimal improvement and 3 minor wound problems occurred. Surgery for hidden penis achieves marked aesthetic and often functional improvement. Surgical failure can be diminished by placing ventral tacking sutures from the tunica albuginea to the subdermis of the penoscrotal junction.

A new approach to the surgical correction of buried penis.

A new approach to the surgical correction of buried penis.

A new approach to the surgical correction of buried penis

Buried penis has been variously attributed to obesity with excessive suprapubic fat, severe phimosis with trapping of the penis within the prepubic tissues, and inadequate fixation of the penile shaft skin at the base resulting in tenting. Previous attempts at surgical correction, by excising suprapubic fat, fixing penile shaft skin to the base of the penis, and circumcising, have failed to give satisfactory results and, indeed, procedures like circumcision will make the condition even worse. The technique developed by the author is based on the recognition that this condition exists because of the displacement of the root of the penis below its normal position, resulting in the surrounding fat and dartos tissues enveloping the penile shaft. In this procedure, dissection at the root of the penis is carried out deep down to the corporal bodies. All fibrotic tissue that binds the penile shaft is excised. The lengthened penile shaft is anchored at its base by suturing the surrounding tissue onto the tunica. This technique has been applied in 22 patients ranging in age from 5 months to 11 years. Apart from two technical problems, all other patients had satisfactory correction with good functional results.