Objectives: The purpose of this lecture is to present current strategies in the management of the buried penis, that represent a physically and psychologically debilitating condition.
Introduction: The condition of hidden penis may arise from several factors.
The pediatric form has been reported as a rare congenital disorder.
Buried penis in adulthood may become an acquired condition most commonly from obesity, radical circumcision, or penoscrotal lymphedema. As obesity has become a national epidemic, the incidence of this phenomenon will inevitably increase. The purpose of this lecture is to present current strategies in the management of this physically and psychologically debilitating condition.
Materials / method: The indications for surgical intervention and
methods of the surgical management of buried penis are described. Some particular cases of clinical presentation are also presented.
Results: Several risk factors were identified in adult patients with buried penis,
including morbid obesity and diabetes mellitus. Multiple techniques for release
and reconstruction are described, including primary closure, Z-plasty, and skin
resurfacing, all of which may or may not include a lipectomy. Recent publications
focus on resurfacing with split-thickness skin grafts and negative-pressure
dressings. These techniques have been successful in terms of graft survival and
long-term cosmetic result.
Conclusion: Buried penis is an unusual, difficult-to-treat condition that presents
a unique challenge to the plastic surgeon and the urologist. Predisposing
factors such as morbid obesity and diabetes mellitus are becoming increasingly
prevalent, which suggests a potential increase in the incidence of this condition.
Although no specific approach may be applicable to all patients, a combination
of various techniques may be applied. Therapy adapted to the individual patient can result in high rates of successful reconstruction with acceptable functional and aesthetic results.
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