Received 28 August 2007; accepted 31 January 2008. published online 17 March 2008.
Objectives
To report our successful experience in managing acquired adult buried penis from nontraumatic origins. We describe a combination of modern techniques involving escutcheonectomy, scrotoplasty, split-thickness skin graft, and fibrin sealant application for genital reconstruction.
Methods
From 2004 through 2007, 5 men with acquired adult buried penis underwent surgical repair at our medical center, by a single surgeon. A buried penis was a result of obesity in 4 of 5 patients, although other complicating factors, such as scrotal lymphedema, lichen sclerosis, and peripenile woody induration, were present in 3 of the 5 patients. All 5 patients required scrotoplasty and split-thickness skin grafts fastened with dilute fibrin glue to cover the penile skin defects. Excision of the excessive suprapubic fat pad (escutcheonectomy) was performed in the 4 obese patients.
Results
All patients achieved excellent cosmetic results, with successful and lasting unburying achieved in all cases. The operative difficulty, intraoperative blood loss, and length of hospital stay varied. No wound complications developed at the skin donor sites, and a rate of 80% to 100% graft take was observed on the penis at 2 months postoperatively. Abdominal wound complications were noted in 2 patients and resolved with daily dressing changes.
Conclusions
Acquired adult buried penis is a correctable problem. The use of combined techniques, including surgical unburying, scrotoplasty, escutcheonectomy, and split-thickness skin grafts fixed with dilute fibrin glue, appears to be a useful approach to repair this unique condition.
aDepartment of Urology, Tri-Service General Hospital, Taipei, Taiwan
bCenter for Urologic Reconstruction, Detroit Receiving Hospital, Detroit Medical Center, Detroit, Michigan
Reprint requests: Richard A. Santucci, M.D., Department of Urology, Detroit Receiving Hospital, UHC 9C-31, 4201 St. Antoine, Detroit, MI 48201.
ABSTRACT