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Abstract
Buried penis is an entity that belongs to a group of conditions referred to as inconspicuous penis. Which is a phallus that is or only appears to be small (Maisels et al., 1986). The buried penis itself is otherwise normal in size but buried in the prepubic fat.
The etiology is not completely clear; however it could be explained by many theories one of which is poor attachments between the shaft skin and underlying fascia.
In this study an anchoring technique was used to suture the penile skin to Buck’s fascia (dynamic stitch) or to pubic bone periostium (static stitch).
Fourty six patients were included and randomly allocated between 2 groups: A (dynamic) B (static). We did not find any significant relation between the age of the patient and the results or the complications, denoting that the optimal age of intervention is at the time of presentation.
An acceptable operative time ranging from 20-35 minutes and 25-40 minutes for both groups respectively.
In group A, the two anchoring stitches were taken at 3 and 9 O’clock positions between the deep dermis of degloved penile skin at the penopubic angle to the Buck’s fascia at the same level using delayed absorbable material (Vicryl 4/0) while in group B; the deep dermal stitches were fixed to the periosteum of the pubic bone instead.
Beyond 3 days post-operative pain was not encountered in group A, while in group B it persisted in 7 patients (30%) with a highly statistically significant difference between the two groups (P-value = 0.002) in favor of group A. Post-operative oedema occurred in 2 patients of group A (0.086%) while in group B it occurred in 10 patients (43%) with a highly statistically significant difference between the two groups (P-value = < 0.001) in favor of group A.
Patients and parents satisfaction was achieved in 22 cases of group A (95%) while in group B it was achieved only in 7 cases (30%) with a highly statistically significant difference between the two group (P-value=0.004) in favor of group A.
Appearance of the sulcus at the root of the penis was noticed only in 3 cases of group A (11.11%) while in group B it was noticeable in all cases (100%) with a highly statistically significant difference between the two groups (P-value = < 0.001) in favor of group A. There were no differences between the two groups concerning the persistence of penile visualization or recurrence over a follow-up period.
Most of the results were in favor of simple (the dynamic stitch) technique denoting its superiority, using delayed absorbable stitch and the optimal time of intervention is at the time of presentation.