title: Patient-Reported Social, Psychological, and Urologic Outcomes After Adult Buried Penis Repair.
abstract: OBJECTIVE
  To assess changes in hygiene, urination, and sexual activity after surgery for adult-acquired buried penis.
  
  
  METHODS
  The study included men who underwent buried penis repair from 2011 to 2015. Patients were asked pre- and postoperative questions on hygiene, urinary difficulties, sexual difficulties, and difficulties with activities of daily living (modified Post-Bariatric Surgery Quality of Life Questionnaire). Postoperative satisfaction was assessed at a minimum of 6 months. Pre- and postoperative data were compared with chi-squared analyses.
  
  
  RESULTS
  Of 14 eligible patients, 12 completed postoperative questionnaires. Buried penis repair required debridement of penile skin with split-thickness skin grafting to penis (n = 11; 92%), escutcheonectomy (n = 12; 100%) and abdominoplasty (n = 10; 83%), scrotoplasty (n = 7; 59%), and securing the supra-penile dermis to the pubic dermal or periosteal tissue (n = 12, 100%). The average length of follow-up was 31 months (±20 months). Mean age was 50 (±10.5 years) and mean body mass index was 55 (±13.7 kg/m2). Wound complications (all Clavian Grade 1) occurred in 9 of 12 patients. Patients reported improvement in hygiene (100%), urination (91%), and sexual function (41%); 92% of patients reported they would choose to have the surgery again; and 83% felt that surgery had led to a positive change in their lives. The ability to perform most activities of daily living, as assessed by the Post-Bariatric Surgery Quality of Life Questionnaire, improved significantly. Over 90% of men had lost additional body weight at last clinical follow-up.
  
  
  CONCLUSIONS
  Buried penis repair positively impacts social, psychological, and functional outcomes for patients. Wound complications should be expected but are easily managed.
authors.affiliation: Department of Urology, University of Iowa, Iowa City, IA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Voznesensky
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Iowa, Iowa City, IA.
authors.forename: W Thomas
authors.initials: WT
authors.lastname: Lawrence
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Iowa, Iowa City, IA.
authors.forename: Jerrod N
authors.initials: JN
authors.lastname: Keith
authors.affiliation: Department of Urology, University of Iowa, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology; D000071066:Patient Reported Outcome Measures; D010409:Penile Diseases / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D010413:Penis / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012725:Sexual Behavior; D017592:Skin Care / Q000379:methods; D016038:Skin Transplantation / Q000379:methods; D013519:Urogenital Surgical Procedures / Q000009:adverse effects* / Q000379:methods