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Original Research

Open Access

Patients with adult-acquired buried penis and their surgical management: a single-center study

  • Melissa Wong1
  • Bryan Torres2
  • Aadit Patel2
  • Abigail Chaffin2
  • David Jansen2
  • Wayne JG Hellstrom1,*,

1Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA

2Division of Plastic Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA

DOI: 10.22514/jomh.2023.112 Vol.19,Issue 11,November 2023 pp.11-15

Submitted: 30 June 2023 Accepted: 22 August 2023

Published: 30 November 2023

*Corresponding Author(s): Wayne JG Hellstrom E-mail: whellst@tulane.edu

Abstract

Adult-acquired buried penis (AABP) is a condition in which the suprapubic fat (the escutcheon) conceals the penis. The etiologies of AABP include obesity, pelvic lymphedema, lichen sclerosis, and scar contraction following a circumcision. If untreated, AABP can lead to hygiene-related infections, urinary and sexual disorders, and psychological issues, such as depression, diminished self-esteem, and poor quality of life. When weight reduction fails to resolve this condition, surgical correction can successfully manage the patient’s AABP. The goal of surgical repair is to extract the telescoped penis from the escutcheon. In our experience, this has been successful with a urologist/plastic surgeon team. Cases of surgical repair for AABP performed at a single medical center from 2012 to 2022 were retrospectively reviewed. Fourteen patients, whose age ranged from 40 to 74 years old, were identified, and their characteristics as well as the surgical techniques performed on them were reviewed. All patients were obese, their body mass index ranging from 32.1 to 62.4; eight patients were severely obese. Five patients had a history of adult circumcision, 5 had a prior diagnosis of lichen sclerosis, and 3 had genital lymphedema. The initial procedures were routine but with some variation. The surgical techniques included performing a panniculectomy and/or an escutcheonectomy, degloving the penis, removing nonfunctional fibrotic tissue, incising the suspensory ligament, and using a meshed split-thickness skin graft (STSG) for penile coverage. The most common complication was wound dehiscence. Two patients with complications required a return to the operating room; one patient returned for closure of an infected wound and the other for penile reconstruction and the placement of a new STSG for lymphedema. All patients eventually recovered, with no further complications reported.


Keywords

Adult-acquired buried penis; Escutcheon; Surgical repair; Meshed split-thickness skin graft


Cite and Share

Melissa Wong,Bryan Torres,Aadit Patel,Abigail Chaffin,David Jansen,Wayne JG Hellstrom. Patients with adult-acquired buried penis and their surgical management: a single-center study. Journal of Men's Health. 2023. 19(11);11-15.

References

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