From the Division of Plastic Surgery, Mount Sinai Health, New York City, NY.
Hansjorg Wyss Department of Plastic Surgery at NYU Grossman School of Medicine, New York, NY.
Ann Plast Surg. 2024 Sep 1;93(3):355-360. doi: 10.1097/SAP.0000000000004025. Epub 2024 Jul 15.
Often secondary to obesity, adult-acquired buried penis (AABP) is an increasingly common condition. AABP is often detrimental to urinary and sexual function, psychological well-being, and quality of life. Surgical treatment involves resection of excess soft tissue, with adjunct procedures, including a panniculectomy. However, few studies have been conducted investigating the risks of panniculectomy in the context of AABP surgical repair.
A systematic review of PubMed, Embase, and Cochrane databases was performed, following the PRISMA 2020 guidelines. Descriptive statistics regarding patient demographics, complications, and surgical technique were conducted. After this, an analysis of AABP patients within the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was conducted.
Four studies including 57 patients reported panniculectomy as part of buried penis repair (PBPR). Surgical approaches included a modified trapezoid and traditional transverse incision. All authors utilized postoperative drains. Dehiscence and wound infection were the most frequent complications. Univariate NSQIP analysis revealed that PBPR patients had higher body mass index, more comorbidities, and greater wound complication rates. Multivariate analysis revealed that PBPR did not significantly increase 30-day complications compared to isolated BPR ( P > 0.05), while body mass index remained a significant predictor.
Surgical repair of AABP can greatly improve patient quality of life. The available literature and NSQIP-based analysis reveal that concurrent panniculectomy in AABP repair has a comparable complication profile. Future studies are necessary to better characterize the long-term outcomes of this PBPR.
成人获得性埋藏阴茎（AABP）常继发于肥胖，是一种日益常见的疾病。AABP 常损害尿和性功能、心理健康和生活质量。手术治疗包括切除多余的软组织，辅助手术包括行腹侧皮瓣切除术。然而，在 AABP 手术修复方面，很少有研究调查腹侧皮瓣切除术的风险。
我们按照 PRISMA 2020 指南对 PubMed、Embase 和 Cochrane 数据库进行了系统评价。对患者人口统计学数据、并发症和手术技术进行了描述性统计。之后，我们对美国外科医师学会国家手术质量改进计划（NSQIP）数据库中的 AABP 患者进行了分析。
四项研究共纳入 57 例患者，报告了腹侧皮瓣切除术作为埋藏阴茎修复术（PBPR）的一部分。手术入路包括改良的梯形和传统的横切口。所有作者均使用术后引流管。切口裂开和伤口感染是最常见的并发症。单变量 NSQIP 分析显示，PBPR 患者的体重指数更高、合并症更多、伤口并发症发生率更高。多变量分析显示，与单纯 BPR 相比，PBPR 并未显著增加 30 天并发症（ P > 0.05），而体重指数仍然是一个显著的预测因素。
AABP 的手术修复可显著改善患者的生活质量。现有的文献和基于 NSQIP 的分析表明，在 AABP 修复中同时行腹侧皮瓣切除术具有相似的并发症谱。需要进一步的研究来更好地描述 PBPR 的长期结果。
