Abstract: PD63-11
Sources of Funding: none

Introduction

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)._x000D_ _x000D_ 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. _x000D_

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.

Funding

none