Surgical management of adult acquired buried penis with concurrent lichen sclerosus: 10-year experience
BAUS ePoster online library. Mann H. 11/10/20; 304151; P6-5
Harvinder Mann
Harvinder Mann
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Surgical management of adult acquired buried penis with concurrent lichen sclerosus: 10-year experience

Hong M1, Mann H1, Anderson P1
1Dudley Group NHS Foundation Trust, United Kingdom

Introduction:
Patients with adult acquired buried penis (AABP) and lichen sclerosus (LS) face a dismal future as the condition progresses relentlessly with chronic moisture and urine trapping due to their body habitus. Penis unburying surgery in these cases aims to expose the glans and halt the disease. We aimed to outline the operative outcomes of a single surgeon series of men with buried penis and LS undergoing penis unburying surgery.
Patient and Methods: Cases were identified from a prospectively maintained operative database of patients undergoing buried penis surgery. Those with indications other than LS were excluded. Case notes were reviewed and details such as demographics, procedural details and complications were documented.

Results:
44 patients underwent surgery for AABP with concomitant LS from 2009 to 2019. They had median age 56yrs (32-82) and median BMI 37 (IQR 35-40). 15 patients had concurrent urethral stricture disease. All patients underwent suprapubic lipectomy, 41 had redo circumcision, each requiring graft coverage with split thickness skin graft. Median operative time was 188min (IQR 180-210) and median length of stay was 5 days (IQR 4-5). Biopsy revealed penile intraepithelial neoplasia in two patients. 16 patients had wound dehiscence. At median follow up of 4 months (IQR 3-10), the glans penis was successfully exteriorised in all patients with inactivation of LS.

Conclusions:
Penis unburying in men with LS has a high rate of success for arresting the LS process, but at the expense of wound complications.
Surgical management of adult acquired buried penis with concurrent lichen sclerosus: 10-year experience

Hong M1, Mann H1, Anderson P1
1Dudley Group NHS Foundation Trust, United Kingdom

Introduction:
Patients with adult acquired buried penis (AABP) and lichen sclerosus (LS) face a dismal future as the condition progresses relentlessly with chronic moisture and urine trapping due to their body habitus. Penis unburying surgery in these cases aims to expose the glans and halt the disease. We aimed to outline the operative outcomes of a single surgeon series of men with buried penis and LS undergoing penis unburying surgery.
Patient and Methods: Cases were identified from a prospectively maintained operative database of patients undergoing buried penis surgery. Those with indications other than LS were excluded. Case notes were reviewed and details such as demographics, procedural details and complications were documented.

Results:
44 patients underwent surgery for AABP with concomitant LS from 2009 to 2019. They had median age 56yrs (32-82) and median BMI 37 (IQR 35-40). 15 patients had concurrent urethral stricture disease. All patients underwent suprapubic lipectomy, 41 had redo circumcision, each requiring graft coverage with split thickness skin graft. Median operative time was 188min (IQR 180-210) and median length of stay was 5 days (IQR 4-5). Biopsy revealed penile intraepithelial neoplasia in two patients. 16 patients had wound dehiscence. At median follow up of 4 months (IQR 3-10), the glans penis was successfully exteriorised in all patients with inactivation of LS.

Conclusions:
Penis unburying in men with LS has a high rate of success for arresting the LS process, but at the expense of wound complications.
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