OBJECTIVES: To describe our buried penis repair technique that includes penile release, tissue resection, wound closure, and penile reconstruction. PATIENTS AND METHODS: In all, 73 patients were treated from 2007 to 2017. Patients can be categorised into five stages: Stage I, involves only a phimotic band; Stage 2, required excision of diseased penile skin with split-thickness skin grafting (STSG); Stage 3, requires scrotal excision; Stage 4, requires escutcheonectomy; and Stage 5, requires panniculectomy. Successful treatment hinges on adequate excision of diseased skin and de-bulking followed by replacement of deficient skin with STSG. RESULTS: In all, 36 of 73 (49%) patients had Stage 1-3 disease, whilst 37 of 73 (51%) were Stage 4-5. There were complications within the first 30 days in 44 of 73 (60%) patients. In all, 62 of 73 (85%) patients either had no complications or Clavien-Dindo grade I-II complications and nine (12%) had complications beyond 30 days. Only five of 36 (14%) patients with Stage 1-3 disease had complications. One patient developed recurrent phimosis. CONCLUSION: The buried penis is a challenging surgical entity where conservative treatment will most likely lead to failure. Surgery is the only means for a lasting cure in these patients and should be used as a first-line treatment. One should expect complications postoperatively, especially within the first 30 days; however, these are mostly limited to Clavien-Dindo grade I-II complications.
OBJECTIVES: To describe our buried penis repair technique that includes penile release, tissue resection, wound closure, and penile reconstruction. PATIENTS AND METHODS: In all, 73 patients were treated from 2007 to 2017. Patients can be categorised into five stages: Stage I, involves only a phimotic band; Stage 2, required excision of diseased penile skin with split-thickness skin grafting (STSG); Stage 3, requires scrotal excision; Stage 4, requires escutcheonectomy; and Stage 5, requires panniculectomy. Successful treatment hinges on adequate excision of diseased skin and de-bulking followed by replacement of deficient skin with STSG. RESULTS: In all, 36 of 73 (49%) patients had Stage 1-3 disease, whilst 37 of 73 (51%) were Stage 4-5. There were complications within the first 30 days in 44 of 73 (60%) patients. In all, 62 of 73 (85%) patients either had no complications or Clavien-Dindo grade I-II complications and nine (12%) had complications beyond 30 days. Only five of 36 (14%) patients with Stage 1-3 disease had complications. One patient developed recurrent phimosis. CONCLUSION: The buried penis is a challenging surgical entity where conservative treatment will most likely lead to failure. Surgery is the only means for a lasting cure in these patients and should be used as a first-line treatment. One should expect complications postoperatively, especially within the first 30 days; however, these are mostly limited to Clavien-Dindo grade I-II complications.
Authors: Mélanie Aubé; Michael Chua; Jessica DeLong; Kurt McCammon; Jeremy Tonkin; David Gilbert; Ramón Virasoro Journal: Int Urol Nephrol Date: 2019-12-03 Impact factor: 2.370