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    Buried penis repair: Videos illustrate aesthetic, functional considerations

     

    Resection, reconstruction of massive lymphedema of the male genitalia

     

     

     

    Jonathan L. Witten, MD, and Daniel D. Dugi III, MD, illustrate their technique of resection and reconstruction of massive lymphedema of the male genitalia. They also present a case series of three men with massive lymphedema of the genitalia treated between 2014 and 2015.

    Dr. Myers: The authors demonstrate a technique for treatment of massive genital lymphedema, which can arise from previous inguinal or genital operations or from obesity. Highlights of their technique are relocation of the penis through the suprapubic fat pad to a more anatomic location and reconstruction of a neo-scrotum through flaps of lateral scrotum and perineum with areas unaffected by lymphedema. In addition, the authors show how a skin graft can be harvested from lymphedematous resected tissue and used with good results for penile skin grafting. Despite the horrendous nature of this problem, the results demonstrated in the video are very impressive.

    Dr. Hotaling: Here, the surgeons illustrate how the excellent vascular supply of the penis and scrotum can be used to facilitate an optimal cosmetic outcome for buried penis repair. Further, their use of the resected tissue for a skin graft also minimizes morbidity for a patient population where postoperative complications are common and have the potential to be devastating.

    Jonathan L. Witten, MDJonathan L. Witten, MD Daniel D. Dugi III, MDDaniel D. Dugi, III, MD

    Dr. Witten is currently a fellow in genitourinary trauma and reconstruction at the University of Alberta in Edmonton, Alberta and will join the faculty of Oregon Health & Science University and Portland VA hospital following the completion of his 1-year fellowship. Dr. Dugi is assistant professor of urology at Oregon Health & Science University. He is co-founder of OHSU’s Transgender Health Program and offers reconstructive urinary and gender-affirming genital surgery. Dr. Myers is an associate professor in the division of urology at the University of Utah. He is co-director of the reconstructive urology center as well as the clinical fellowship in genitourinary injury and reconstructive urology.

     

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