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. 2013 Dec 29:2013:109349.
doi: 10.1155/2013/109349. eCollection 2013.

Buried penis: evaluation of outcomes in children and adults, modification of a unified treatment algorithm, and review of the literature

I C C King  1 , A Tahir  1 , C Ramanathan  1 , H Siddiqui  1
Affiliations

Buried penis: evaluation of outcomes in children and adults, modification of a unified treatment algorithm, and review of the literature

I C C King et al. ISRN Urol. .

Abstract

Introduction. Buried penis is a difficult condition to manage in children and adults and conveys significant physical and psychological morbidity. Surgery is often declined due to morbid obesity, forcing patients to live in disharmony for years until the desired weight reduction is achieved. No single operative technique fits all. We present our experience and surgical approach resulting in an improved algorithm unifying the treatment of adults and children. Methods. We conducted a retrospective analysis of patients treated for buried penis between 2011 and 2012. All patients underwent penile degloving and basal anchoring. Penile shaft coverage was achieved with skin grafts. Suprapubic lipectomies were performed on adult patients. Results. Nine patients were identified: four children and five obese adults. Average postoperative stay was three days for children and five for adults. Three adults were readmitted with superficial wound problems. One child had minor skin breakdown. All patients were pleased with their outcomes. Conclusion. Buried penis is a complex condition, and treatment should be offered by services able to deal with all aspects of reconstruction. Obesity in itself should not delay surgical intervention. Local and regional awareness is essential to manage expectations in these challenging patients aspiring to both aesthetic and functional outcomes.

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Figures

Figure 1
Figure 1
Treatment algorithm for adults and children with buried penis (adapted from [9]).
Figure 2
Figure 2
Penile skin coverage demonstrating delivery of the penis from tethering tissue and resurfacing with fenestrated skin graft draped dorsally to recreate the ventral raphe.
Figure 3
Figure 3
Suprapubic lipectomy can uncover the penile base position (being pointed centrally) and provide a useful skin graft donor site.
Figure 4
Figure 4
Buried penis in a 2-year-old child and the postoperative skin grafted penis at the age of 4.
Figure 5
Figure 5
An adult with buried penis who underwent penile shaft resurfacing.
See this image and copyright information in PMC

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