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    Buried penis repair: Videos illustrate aesthetic, functional considerations


    Correction of concealed penis with panniculectomy, penile skin graft



    This video, from Alex Vanni, MD, depicts correction of concealed penis with panniculectomy and penile skin graft in a 63-year-old man with morbid obesity whose penis was completely concealed for 7 years.

    Dr. Myers: Dr. Vanni demonstrates repair of buried penis in a patient with morbid obesity. Their technique involves panniculectomy of the suprapubic fat pad with fixation of the fat pad to the deep tissue overlying the pubis. Reconstruction of the peno-scrotal and peno-abdominal junction is performed with a flap of redundant scrotum. The penile skin graft is applied with a bolster type of dressing. Their meticulous technique is evident throughout the video.

    Dr. Hotaling: Dr. Vanni demonstrates how both removal of and fixation of the suprapubic fat pad are required to fix the penoscrotal junction in an optimal anatomic and functional location. The use of a bolster is a critical part of this surgery and greatly facilitates optimal wound healing and cosmetic appearance of the shaft skin. Although this may seem like a trivial portion of the operation, stabilization of grafted tissue in the morbidly obese patient is incredibly complex yet vital to an optimal outcome.

    Alex Vanni, MDAlex Vanni, MD

    Dr. Vanni is assistant professor at the Tufts University Medical Center and co-director of the Center for Reconstructive Urologic Surgery, Burlington, MA.



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