V901: Surgical Technique: Limited Panniculectomy for Adult Buried Penis Repair
VideoIntroduction and Objectives
Patients with buried penis may be unable to urinate with a directable urine stream or be sexually active as a result of the condition. Though these patients are nearly always obese, weight loss often does not reverse the problem, as the mons pannus may remain after weight loss, and phimosis of the surrounding skin will persist. Treatment includes removal of the diseased skin surrounding the penis, typically in the form of a limited panniculectomy and penile degloving. We present our technique for this procedure in a typical patient with buried penis that prevents him from voiding effectively.
We begin with a panniculectomy incision and then expose the pubic symphysis. In order to increase the exposed penile length, tacking sutures are placed between the pubic symphysis and the skin at the base of the penis. If the penile skin is diseased, this skin is removed, and replaced with a meshed or non-meshed split thickness skin graft, which is typically taken from the thigh at a thickness of 14/1,000 inch. The patient is maintained on bedrest while the skin graft takes.
This patient enjoyed an excellent functional outcome, with an exposed penis that allows him to effectively void with a directable urine stream.
Our approach to buried penis repair is straight-forward, effective, and leads to durable functional outcomes.