Azouz V, Kareh A and Bialowas C*
Department of Surgery, University of Texas Health Science Center, USAFulltext PDF
Buried penis is a rare debilitating phenomenon that has been associated with obesity, lymphedema, radical circumcision, and penoscrotal elephantiasis. Traditional management of this condition involves limited panniculectomy, excision of penile shaft skin, and skin grafting. Buried penis secondary to massive localized lymphedema of the scrotum is seldom described in the literature and further complicates the use of local reconstruction as local tissue is damaged and may be unfit for reconstructive purposes. The authors report the case of a morbidly obese patient with buried penis secondary to massive localized lymphedema of the scrotum reconstructed using a panniculus flap and delayed penile skin grafting. After undergoing scrotal reconstruction using a panniculus flap, the patient returned to the operating room five days later to undergo penile reconstruction with meshed split thickness skin grafting. Sequential compression wrapping between the first and second procedures allowed the swelling and edema to decrease significantly so that the penile bed would be more amenable to split thickness skin graft. In treating buried penis in the setting of massive scrotal lymphedema, the authors propose reconstructive staging and sequential compression dressings between procedures to maximize patient safety by limiting postoperative complications and minimize edema.
Buried penis; Massive localized lymphedema; Scrotal reconstruction
Azouz V, Kareh A, Bialowas C. Use of Panniculus Flap with Delayed Penile Reconstruction for Management of Buried Penis in a Patient with Massive Localized Lymphedema of the Scrotum: A Case Report. Clin Surg. 2016; 1: 1081.