Surgical management and outcomes of adult acquired buried penis with and without lichen sclerosus: a comparative analysis
| Autor: | David A. Gilbert, M Francesca Monn, Mélanie Aubé, Gerald H. Jordan, Ramón Virasoro, Michael Chua, Kurt A. McCammon, Jessica DeLong |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Urologic Surgical Procedures Male Urethral stricture Urology Population 030232 urology & nephrology 030204 cardiovascular system & hematology Lichen sclerosus Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine medicine Humans Chronic dermatosis Acquired buried penis education Aged Retrospective Studies education.field_of_study business.industry Retrospective cohort study Middle Aged medicine.disease Surgery Lichen Sclerosus et Atrophicus Treatment Outcome Concomitant business Penis |
| Zdroj: | International Urology and Nephrology. 52:1893-1898 |
| ISSN: | 1573-2584 0301-1623 |
| DOI: | 10.1007/s11255-020-02486-y |
| Popis: | Adult acquired buried penis (AABP) can present with concomitant Lichen Sclerosus (LS), a chronic dermatosis that may affect surgical outcomes. Our aim was to evaluate outcomes of patients undergoing AABP repair with and without LS. A retrospective cohort study was performed for AABP repair patients at a single institution from 1/1991 to 12/2017. Patient characteristics and surgical and peri-operative outcomes, including success, erectile function, and complications, were collected. Sixty-seven AABP patients with mean follow-up of 16.1 ± 20.4 months were identified. Overall surgical success was 91%. Overall surgical complication rate was 50.7% (23.9% Clavien-Dindo ≥ 3). Forty-two (62.7%) patients had concomitant LS. A higher proportion of patients with LS required a STSG (90% vs 60%, p = 0.005). There was no difference in surgical success (90.5% vs 92.0%, p = 0.999), overall complication rate (57.1% vs 40.0%, p = 0.212), Clavien-Dindo ≥ 3 complications (23.8% vs 24.0%, p = 0.999) or early complications (35.7% vs 32.0%, p = 0.797) between patients with and without LS, respectively. However, a higher proportion of patients with LS experienced late complications (33.3% vs 8.0%, p = 0.020), which were mainly related to wound healing. Satisfaction with erectile function was higher among patients with LS (59.5% vs 320%, p = 0.043). AABP patients with LS behave somewhat differently than their non LS counterparts. They are more likely to require skin graft during surgical treatment. Though surgical success and complications are similar, they do experience a higher rate of late complications from impaired wound healing. Work on improving wound healing in this population should be considered. |
| Databáze: | OpenAIRE |
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