Surgical Management of Adult-Acquired Buried Penis: Benefits, Harms, and Complications.

What is it about?

The systematic review examined 170 studies and included 21 studies with 570 patients to determine the benefits and harms of surgical techniques for correcting adult-acquired buried penis (AABP). The review found that high-complexity reconstructive procedures were performed, with split-thickness skin grafts for shaft reconstruction. The pooled mean operating time was 192.2 min and the mean estimated blood loss range was 57-326 mL. The incidence of postoperative complications varied across studies (0-80.8%), with >Grade 4 complications reported in 3.1-3.7% of cases. Wound infection and genital lymphoedema were reported in 4.7-33% and 7.1-60% of cases, respectively. The incidence of graft contracture and partial/total loss was 2.4-14.3% and 1.5-21%, respectively. The incidence of recurrence was not systematically reported and ranged from 5.2% to 13%. Postoperative evaluation of functional outcomes demonstrated significant improvements in sexual function, urinary function and cosmesis. However, the high incidence of graft-related complications should be taken into account when counseling patients and AABP care should be centralized to high-volume centers.

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Why is it important?

This research is important because it provides a comprehensive systematic review of the surgical management of adult-acquired buried penis (AABP), which can help urological surgeons to better understand the disease and improve patient counseling. The study highlights the high incidence of complications associated with surgical procedures for AABP but also shows that the results are satisfactory, with significant improvements in patients' quality of life. The study emphasizes the need for a high level of evidence in this emerging field of male genital reconstructive surgery to improve patient outcomes and quality of care. Key Takeaways: 1. Surgical management of AABP has a high incidence of complications but results in satisfactory outcomes, with significant improvement in patients' quality of life. 2. The high incidence of graft-related complications should be taken into account when counseling patients, and AABP care should be centralized to high-volume centers. 3. A detailed medical history, comprehensive patient counseling, and management in a high-volume center for genital reconstruction are the key elements required to minimize the incidence of complications. 4. Preoperative structured weight loss and exercise programs can help mitigate the risk of metabolic syndrome and its sequelae, reducing the incidence of complications.