A Simplified Adult Acquired Buried Penis Repair Classification System With an Analysis of Perioperative Complications and Urethral Stricture Disease

Joseph J Pariser, Omar E. Soto-Aviles, Brandi Miller, Maha Husainat, Richard A. Santucci

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category. Methods: Patients undergoing buried penis repair at a single institution were examined. Classification was as follows: Category I—penile unburying with local flap; II—skin graft; III—scrotal surgery; IV—escutcheonectomy; V—abdominal panniculectomy. Complex repairs were Category III or above. Success was defined as an unburied penis without additional unburying surgery. Results: Between 2007 and 2017, 64 patients underwent repair with 44 (69%) considered complex. Patients undergoing complex repairs had a higher body mass index (median 48 vs 36 kg/m2, P <.01). A total of 30 patients (47%) had urethral strictures, with no association to buried penis complexity (P =.43). High-grade complications (Clavien ≥ 3) occurred in 10 patients (23%) in the high-complexity group with none in the low-complexity group (P =.02). Seven of 10 (70%) of high-grade complications were wound related. Successful unburying was seen in 58 patients (91%). All failures occurred in the high-complexity group. Median follow-up was 209 days. Conclusion: Buried penis repairs are highly successful. We propose a classification based on surgical complexity. Patients requiring complex repairs have higher body mass index and increased risk of high-grade complications. While urethral strictures are found in nearly half of patients, there is no association with the severity of disease. Ongoing modifications of technique and perioperative care may improve outcomes.

Original languageEnglish (US)
Pages (from-to)248-252
Number of pages5
JournalUrology
Volume120
DOIs
StatePublished - Oct 1 2018

Fingerprint

Urethral Diseases
Urethral Stricture
Penis
Body Mass Index
Abdominoplasty
Perioperative Care
Transplants

PubMed: MeSH publication types

  • Journal Article

Cite this

A Simplified Adult Acquired Buried Penis Repair Classification System With an Analysis of Perioperative Complications and Urethral Stricture Disease. / Pariser, Joseph J; Soto-Aviles, Omar E.; Miller, Brandi; Husainat, Maha; Santucci, Richard A.

In: Urology, Vol. 120, 01.10.2018, p. 248-252.

Research output: Contribution to journalArticle

Pariser, Joseph J ; Soto-Aviles, Omar E. ; Miller, Brandi ; Husainat, Maha ; Santucci, Richard A. / A Simplified Adult Acquired Buried Penis Repair Classification System With an Analysis of Perioperative Complications and Urethral Stricture Disease. In: Urology. 2018 ; Vol. 120. pp. 248-252.
@article{3d200659cb4647a8b94b442780febe7b,
title = "A Simplified Adult Acquired Buried Penis Repair Classification System With an Analysis of Perioperative Complications and Urethral Stricture Disease",
abstract = "Objective: To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category. Methods: Patients undergoing buried penis repair at a single institution were examined. Classification was as follows: Category I—penile unburying with local flap; II—skin graft; III—scrotal surgery; IV—escutcheonectomy; V—abdominal panniculectomy. Complex repairs were Category III or above. Success was defined as an unburied penis without additional unburying surgery. Results: Between 2007 and 2017, 64 patients underwent repair with 44 (69{\%}) considered complex. Patients undergoing complex repairs had a higher body mass index (median 48 vs 36 kg/m2, P <.01). A total of 30 patients (47{\%}) had urethral strictures, with no association to buried penis complexity (P =.43). High-grade complications (Clavien ≥ 3) occurred in 10 patients (23{\%}) in the high-complexity group with none in the low-complexity group (P =.02). Seven of 10 (70{\%}) of high-grade complications were wound related. Successful unburying was seen in 58 patients (91{\%}). All failures occurred in the high-complexity group. Median follow-up was 209 days. Conclusion: Buried penis repairs are highly successful. We propose a classification based on surgical complexity. Patients requiring complex repairs have higher body mass index and increased risk of high-grade complications. While urethral strictures are found in nearly half of patients, there is no association with the severity of disease. Ongoing modifications of technique and perioperative care may improve outcomes.",
author = "Pariser, {Joseph J} and Soto-Aviles, {Omar E.} and Brandi Miller and Maha Husainat and Santucci, {Richard A.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.urology.2018.05.029",
language = "English (US)",
volume = "120",
pages = "248--252",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - A Simplified Adult Acquired Buried Penis Repair Classification System With an Analysis of Perioperative Complications and Urethral Stricture Disease

AU - Pariser, Joseph J

AU - Soto-Aviles, Omar E.

AU - Miller, Brandi

AU - Husainat, Maha

AU - Santucci, Richard A.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objective: To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category. Methods: Patients undergoing buried penis repair at a single institution were examined. Classification was as follows: Category I—penile unburying with local flap; II—skin graft; III—scrotal surgery; IV—escutcheonectomy; V—abdominal panniculectomy. Complex repairs were Category III or above. Success was defined as an unburied penis without additional unburying surgery. Results: Between 2007 and 2017, 64 patients underwent repair with 44 (69%) considered complex. Patients undergoing complex repairs had a higher body mass index (median 48 vs 36 kg/m2, P <.01). A total of 30 patients (47%) had urethral strictures, with no association to buried penis complexity (P =.43). High-grade complications (Clavien ≥ 3) occurred in 10 patients (23%) in the high-complexity group with none in the low-complexity group (P =.02). Seven of 10 (70%) of high-grade complications were wound related. Successful unburying was seen in 58 patients (91%). All failures occurred in the high-complexity group. Median follow-up was 209 days. Conclusion: Buried penis repairs are highly successful. We propose a classification based on surgical complexity. Patients requiring complex repairs have higher body mass index and increased risk of high-grade complications. While urethral strictures are found in nearly half of patients, there is no association with the severity of disease. Ongoing modifications of technique and perioperative care may improve outcomes.

AB - Objective: To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category. Methods: Patients undergoing buried penis repair at a single institution were examined. Classification was as follows: Category I—penile unburying with local flap; II—skin graft; III—scrotal surgery; IV—escutcheonectomy; V—abdominal panniculectomy. Complex repairs were Category III or above. Success was defined as an unburied penis without additional unburying surgery. Results: Between 2007 and 2017, 64 patients underwent repair with 44 (69%) considered complex. Patients undergoing complex repairs had a higher body mass index (median 48 vs 36 kg/m2, P <.01). A total of 30 patients (47%) had urethral strictures, with no association to buried penis complexity (P =.43). High-grade complications (Clavien ≥ 3) occurred in 10 patients (23%) in the high-complexity group with none in the low-complexity group (P =.02). Seven of 10 (70%) of high-grade complications were wound related. Successful unburying was seen in 58 patients (91%). All failures occurred in the high-complexity group. Median follow-up was 209 days. Conclusion: Buried penis repairs are highly successful. We propose a classification based on surgical complexity. Patients requiring complex repairs have higher body mass index and increased risk of high-grade complications. While urethral strictures are found in nearly half of patients, there is no association with the severity of disease. Ongoing modifications of technique and perioperative care may improve outcomes.

UR - http://www.scopus.com/inward/record.url?scp=85052335029&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052335029&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2018.05.029

DO - 10.1016/j.urology.2018.05.029

M3 - Article

C2 - 29898381

AN - SCOPUS:85052335029

VL - 120

SP - 248

EP - 252

JO - Urology

JF - Urology

SN - 0090-4295

ER -