New surgical approach for buried penis with partial release of the penile suspensory system associated with fat transfer and suprapubic retraction.

BACKGROUND

Adult acquired buried penis (AABP) is a condition of entrapment of the phallus resulting most commonly from obesity. This condition has a significant negative impact on the quality of life, including micturate difficulties, sexual dysfunction and recurrent infections. Many techniques exist to treat AABP; however, do not necessarily include a suspensory ligament release. The ligamentous system supporting the penis is widely called the "penile suspensory ligament" and is composed of four ligaments.

OBJECTIVES

We wanted to explore the clinical outcomes on an exploratory patient cohort for penis-lengthening in patients with Grade 1 buried penis using a partial release of the penile suspensory system associated with fat transfer combined with a suprapubic retraction.

METHODS

Under general anesthesia, an abdominal liposuction was performed, followed by a direct defatting of the pubic mons. Then the fundiform, the suspensory and the anterior part of the vertical dense ligaments were severed. Furthermore, several anchoring sutures were added and a retropulsion of the supra pubic area was performed. Finally, the purified fat was injected into the penile shaft in a superficial plane. Files from patients who underwent surgery for stage 1 buried penis between 2015 and 2020 were retrospectively reviewed.

RESULTS

Twelve patients with a buried penis underwent a lengthening procedure. The mean augmentation in length was 100% [28.6-218.2] and a mean augmentation of 85.7% [18.2-216.7] in width.

CONCLUSIONS

We described a safe and reproducible technique for penile augmentation in patients with a stage 1 AABP.

LEVEL OF EVIDENCE: Level III, cohort analytic study.