Surgery for buried penis and scrotal lymphedema

Overview 

Buried penis is a condition where the penis, though normal in size, is hidden beneath the skin of the abdomen, thigh, or scrotum due to poor skin fixation at its base, often caused by obesity. On the other hand, scrotal lymphedema is characterized by fluid buildup and swelling in the soft tissues of the genital area due to damage or blockage in the lymphatic system, which can result from cancer treatments or surgeries. Both conditions affect the genital area but stem from different underlying issues. 

Risks 

Surgery for buried penis and lymphedema is generally successful, with a low risk of the condition recurring. Most individuals who undergo surgery for buried penis or lymphedema experience normal urination and sensation in the genital area afterward. However, there are potential complications, including:  

• Penis swelling.   
• Excruciating erections.  
• Reduced sensitivity in the vaginal region.  
• Poor skin graft healing.

Speak with your healthcare physician if you or your kid exhibit any of these symptoms.  

During the procedure  

Surgery for buried penis and scrotal lymphedema is a complex procedure usually considered after non-invasive treatments, such as weight loss for obese individuals or compression therapy for lymphedema, have proven ineffective. The surgery often involves a collaborative team of a urologist and a plastic surgeon.  

The operation is performed under general anesthesia and typically requires a hospital stay. For overweight or obese patients, the procedure may also include the removal of excess fatty tissue from the abdomen.

The surgical process generally involves the following steps:  

1. Catheter Insertion: A catheter is inserted into the urethra to stabilize the penis and protect the urethra.  
2. Degloving: The penis shaft is carefully separated from the surrounding tissues.  
3. Tissue Removal: Any infected or scarred tissue is removed.  
4. Ligament Cutting: The ligament connecting the pubic bone to the base of the penis may be cut.  
5. Suction Lipectomy: Small incisions are made, and fat cells are removed using surgical suction catheters.  
6. Panniculectomy: The excess skin and fat (pannus) hanging over the thighs or genitalia is removed.  
7. Escutheonectomy: The fat pad above the pubic region is removed.

If necessary, skin grafts may be used to cover the penile shaft after degloving. These grafts are typically taken from the thigh. In cases where the buried penis is due to scrotal lymphedema, skin grafts might also be required, though there is often sufficient unaffected skin available for scrotal reconstruction without grafting.  

Outcome 

Antibiotic prescriptions are typically written for a week, though occasionally longer. After surgery, adults can return home three or four days later, but they still need to come back a week later for a graft check and catheter removal. After surgery, children can usually return home without the need for antibiotics. You will need to see a doctor for at least a year after your procedure, and you will see your doctor as an outpatient in four to six weeks.