Results of a simplified technique for buried penis repair

The buried penis can cause secondary phimosis, recurrent balanitis and social embarrassment. We report our results using a simplified technique for repair.

A retrospective chart review of 83 consecutive patients undergoing buried penis repair between March 1995 and March 2001 was performed. Indications for surgery included recurrent balanitis, secondary phimosis, difficulty holding the penis during voiding, spraying of the urinary stream, or parental or patient concern for social embarrassment. The technique involves fixation of the subcutaneous penile skin at the base of the degloved penis to Buck's fascia of the penile shaft at the 3 and 9 o'clock positions.

For the 79 patients included in the study average followup was 4.4 years. Group 1 consisted of 26 patients who underwent circumcision at the time of buried penis repair. Six patients had hypospadias and 13 had penoscrotal webbing that was repaired simultaneously. Three patients (11.5%) had recurrent buried penis that required a repeat procedure and 1 (3.8%) required revision of the circumcision only. Three patients (11.5%) with penoscrotal webbing had mild recurrence requiring no further treatment. Group 2 consisted of 49 patients who underwent revision of the circumcision at the time of buried penis repair. Seven patients (14.3%) had mild recurrence that did not require further treatment. Group 3 consisted of 4 patients who underwent liposuction at the time of buried penis repair. One patient experienced lymphedema of the ventral distal shaft skin, which required subsequent excision.

The buried penis repair is a simple and effective outpatient procedure with few complications and recurrences. It can be used as a primary or secondary procedure and affords good cosmetic results.