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Circumcision, meatotomy, meatoplasty, and preputioplasty
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rachel Harwood, Simon E. Kenny
Removal of too little skin can cause annular scarring at the line of excision and recurrence of the phimosis. In such cases, a further circumcision is required. Removal of too much skin may give the appearance of a buried penis, but only rarely is skin grafting required to achieve a satisfactory appearance.
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
What are the contra-indications to circumcision?HypospadiasBuried penis
Circumcision and disorders of penis
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Concealed or buried penis appears small and is secondary to inadequate attachment of the dartos or spermatic fascia to the deeper Buck’s fascia. The diameter and stretched penile length are normal. Earlier thinking was that this condition was due to childhood obesity (prominent prepubic fat) or inadequate or overzealous circumcision. It was believed that it would correct itself over time with growth. However, experience has suggested that this retrussive penile appearance cannot and does not correct itself.
Penile reconstruction: An up-to-date review of the literature
Published in Arab Journal of Urology, 2021
Nicholas Ottaiano, Joshua Pincus, Jacob Tannenbaum, Omar Dawood, Omer Raheem
Proposed and performed purposes for cosmetic penile surgery include buried penis disease with the goal to improve penile lengthening. Buried penis disease occurs most often in men who have become obese. Adult-acquired buried penis (AABP) is diagnosed by the accumulation of fat tissue thus affecting the lower abdominal skin and soft tissue advancing over the penis [40]. Consequently, this makes the penis decrease in length or become completely buried [41]. Patients with AABP typically present with poor sexual function including urinary dribbling, skin break, urethral strictures, mood disturbance, lichen sclerosis, and poor quality of life [42,43]. The first line of treatment is weight loss; however, this may not resolve AABP due to permanent fibrotic penile skin changes along with lymphoedema of the escutcheon. Most patients will need surgery for long-term management of AABP.
Penile Sparing Techniques For Penile Cancer
Published in Postgraduate Medicine, 2020
There are multiple reconstructive techniques to help improve cosmesis and function after PST. A split thickness skin graft, usually obtained from the thigh, can be used to reconstruct the glans to improve postoperative esthetic after glansectomy [76]. However, the reconstructed meatus may be in an abnormally ventral position and at high risk for meatal stenosis. Kranz et al. [77] proposed a novel technique after grafting with the creation of a pseudo-glans and a wider meatus to restore the meatus in its normal location and reduce the risk of stenosis. Furthermore, Malone et al. [78] tie-over dressing for graft application immobilizes the graft to the corporal bodies and allows for prompt return of patient mobility and shorter hospitalization. The length of the penile stump after glansectomy and partial penectomy can be enhanced by mobilizing the corpora off the pubic arch, excising the suspensory ligament of the penis, and releasing the ventral penoscrotal webbing. The penile stump can then be anchored to the pubic bone to prevent retraction [79]. While initially used to increase perceived penile length in patients undergoing penile implants, Wallen et al. [80] incorporated the ventral phalloplasty technique after partial penectomy. A transverse ‘V’-shaped excision at the penoscrotal junction is made and the wound is then closed in a longitudinal fashion to improve penile cosmesis. Lastly, excision of the mons pubic fat in obese patients with buried penis or placement of a penile prosthesis are potential adjunctive measures to penile length and function.