Background and objective

. Buried penis is a frequent claim in pediatric outpatient clinic. Usually the cavernous bodies and the gland are normal but the penis is buried in the excess suprapubic fat, with no fixation of the peno-pubic angles.

We present our series of patients treated with an alternative to the classic surgical treatment.

Methods

Our surgical technique has been modified in the last 10 years to include a suprapubic Z-plasty in order to get enough skin to cover the base of the penis, lipectomy with section of the suspensory ligament of the penis and fixation of the penopubic angles. We conduct a retrospective study of our patients, collecting data about age, complications and aesthetic results.

Results

Sixteen patients with a mean age of 9 years were operated. The modified surgical technique was applied to all patients; bandage and bladder catheter were removed after 24 hours in all cases. Short-term complications were partial loss of the Z-plasty flap that cured by secondary intention in 2 patients and in 6 patients a significant edema of the preputial mucosa was observed.

Mean follow-up was longer than 5 years in all cases. At the end of follow-up, both patients and parents were satisfied with the results.

Conclusion

The gold-standard surgical technique for the buried penis is still controversial. In our experience, the suprapubic approach in patients with pubic fat hypertrophy, provides better aesthetic appearance with fewer long-term relapses and a clear psychological impact.

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