Objective: To demonstrate a technique for performing panniculectomy and skin graft for a patient with adult buried penis, highlighting a number of technical modifications that allow for the procedure to be performed as an outpatient.
Methods: Pannus is mobilized with a modified trapezoid incision, leaving superior attachments intact for skin graft harvest. Diseased penile skin is removed, defect is measured, and an appropriately sized split thickness skin graft is harvested from the pannus in 2-inch sections at a depth of 18/1000. The unmeshed graft is applied to the penis and covered with a bolster that is secured to the penis for 5-7 days. Patients are discharged postoperative day 0 or 1.
Results: From 2017 to 2019, 19 patients underwent outpatient adult-buried penis repair. Median follow-up was 11.5 months. Median age was 70 years, median body mass index was 43.4, 9 (47%) patients had pathologically confirmed lichen sclerosus. Graft take was ≥95% in all patients. Complications included cellulitis (5, 26%) and minor dehiscence (3, 16%). No patients experienced deep vein thrombosis.
Conclusion: Outpatient panniculectomy and skin graft is an effective treatment option for patients with adult buried penis.
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