Background: Adult acquired buried penis (AABP) is a complex condition often necessitating surgical intervention. This study sought to examine the validity of the Wisconsin Classification System (WCS) in guiding the surgical management of AABP. In addition, the authors aimed to identify which factors contribute to postoperative complications and persistent symptoms following AABP repair.
Methods: The authors retrospectively reviewed all patients who underwent surgical repair of AABP from 2015 to 2021 by the senior author at our institution. Patients were categorized according to anatomical characteristics using the WCS. Preoperative symptoms, postoperative symptoms, and postoperative complications were evaluated.
Results: Fifty-two patients underwent AABP repair. The mean patient age was 56.5 ± 14.8 years, and the mean duration of follow-up was 350.0 ± 517.4 days. The assigned preoperative WCS score was congruent with operative management in most patients (86.0%). Morbid obesity (body mass index >40.0 kg/m 2 ) and postoperative complications were associated with persistent symptoms following AABP repair ( P = 0.026 and P = 0.021, respectively). Increased WCS score was not associated with persistent postoperative symptoms ( P = 0.314). Morbid obesity ( P = 0.003), diabetes ( P = 0.029), and having a panniculectomy during AABP repair ( P = 0.046) increased the odds of developing postoperative complications. Patients with type I AABP had significantly fewer complications than those with type II, III, or IV AABP ( P = 0.032).
Conclusions: The WCS serves as a preoperative guide and an educational tool for patients, and it provides a framework for the discussion of intraoperative maneuvers and the likelihood of complications. It is imperative that patients are counselled on the surgical management of AABP and the postoperative course, as this may permit realistic patient expectations and optimize outcomes.
Clinical question/level of evidence: Risk, III.
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