From the Division of Plastic and Reconstructive Surgery.
Department of Urology, University of Wisconsin School of Medicine and Public Health.
Plast Reconstr Surg. 2024 May 1;153(5):1151-1160. doi: 10.1097/PRS.0000000000010868. Epub 2023 Jun 20.
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.
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.
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).
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.
成人获得性埋藏阴茎（AABP）是一种复杂的疾病，通常需要手术干预。本研究旨在检验威斯康星分类系统（WCS）在指导 AABP 手术管理中的有效性。此外，作者还旨在确定哪些因素导致 AABP 修复后出现术后并发症和持续症状。
作者回顾性分析了 2015 年至 2021 年期间由资深作者在本院行 AABP 手术修复的所有患者。根据 WCS，根据解剖学特征对患者进行分类。评估术前症状、术后症状和术后并发症。
52 例患者行 AABP 修复。患者平均年龄为 56.5±14.8 岁，平均随访时间为 350.0±517.4 天。大多数患者的术前 WCS 评分与手术管理相符（86.0%）。病态肥胖（体重指数>40.0kg/m 2 ）和术后并发症与 AABP 修复后持续症状相关（P=0.026 和 P=0.021）。增加的 WCS 评分与持续的术后症状无关（P=0.314）。病态肥胖（P=0.003）、糖尿病（P=0.029）和 AABP 修复时行腹脂切除术（P=0.046）增加了术后并发症的发生几率。与 II 型、III 型或 IV 型 AABP 相比，I 型 AABP 患者的并发症明显更少（P=0.032）。
WCS 可作为术前指导和患者的教育工具，为术中操作和并发症发生的可能性提供了框架。必须对患者进行 AABP 的手术管理和术后过程进行咨询，这可以使患者有现实的期望并优化结果。
临床问题/证据水平：风险，III。
