Surgical Management of Adult Acquired Buried Penis
Summary
Adult acquired buried penis is a condition in which the penile shaft becomes enveloped by overlying skin and adipose tissue, most often in the context of morbid obesity. Patients typically present with voiding difficulties, recurrent infections, lichen sclerosus and psychological distress. Surgical correction aims to restore function, cosmesis and ease of hygiene. Core principles include complete degloving of the penile shaft, excision of excess suprapubic fat and skin, fixation of the penis to stable deep structures and reconstruction of the penoscrotal angle. Techniques vary according to local tissue quality, the presence of urethral strictures or dermatological comorbidities and patient factors such as body mass index. Common reconstructive options include placement of split‐thickness or full‐thickness skin grafts, use of local flaps such as musculocutaneous scrotal flaps and novel suturing procedures to secure the tunica albuginea to the pubic periosteum or ligament. A multidisciplinary approach—encompassing nutritional support, wound care, urological and psychological assessment—optimises outcomes and minimises complications such as graft loss, flap necrosis, infection and stricture recurrence.
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Surgical Management of Adult Acquired Buried Penis publication trend
The graph below shows the total number of articles in surgical management of adult acquired buried penis across all publications each year (not limited to Nature Index journals).
Technical terms
Buried penis: A condition in which the penile shaft is concealed under overlying skin and fat, often due to obesity or post‐surgical scarring.
Suprapubic adipose tissue: Fat deposits located above the pubic bone that can envelop the penile shaft.
Urethral stricture: Narrowing of the urethral lumen, which can contribute to urinary obstruction and requires endoscopic or open repair.
Lichen sclerosus: A chronic inflammatory dermatosis of the genital skin that can cause scarring, strictures and malignancy risk.
Split-thickness skin graft (STSG): A graft comprising epidermis and a portion of dermis, used to resurface denuded penile tissue.
Full-thickness skin graft (FTSG): A graft that includes the entire dermal layer, offering greater durability and reduced contraction.
Dermal matrix: A bioengineered scaffold placed beneath a skin graft to support vascularisation and wound healing.
Tunica albuginea: The fibrous envelope of the corpora cavernosa to which sutures are anchored for penile fixation.
Prepubic ligament: Fibrous tissue adjacent to the pubic bone that serves as a stable anchor point during reconstruction.
References
- Incidence of Urethral Stricture in Patients with Adult Acquired Buried Penis. Advances in Urology (2017).
- A new surgical technique for concealed penis using an advanced musculocutaneous scrotal flap. BMC Urology (2015).
- Adult Acquired Buried Penis: A Hidden Problem in Obese Men. Cureus (2021).
- A novel “six stitches” procedures for pediatric and adult buried penis. International braz j urol (2019).
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