(201) REAL WORLD COMPLICATIONS FOLLOWING BURIED PENIS REPAIR WITH SKIN GRAFTING

Abstract Introduction With rising prevalence of obesity in the United States, adult acquired buried penis (AABP) is an increasingly widespread problem. It impacts sexual function, personal hygiene, urination, self-esteem, and quality of life. As surgery is the cornerstone of definitive management, understanding complication rates in the real world is essential for adequate counseling and setting patient expectations. Objective In this study, we sought to describe our experience managing AABP and discuss rates of complications following surgery. We also sought to understand risk factors for complications. Methods We performed a single-institution, single-surgeon retrospective study of AABP managed with escutcheonectomy and skin grafting. Complications included wound infection, urinary tract infection, dehiscence, recurrence of AABP, any degree of graft loss, and mortality. We also collected demographic data, including age, comorbidities, and BMI. Results We identified 29 cases between February 2020 and March 2024. Of those, 26 patients (90%) had a complication – the most common being wound infection (55%) and partial or complete graft loss (41%). Those with complications following surgery had a higher body mass index than those without complications (46 kg/m2 vs 32 kg/m2, p = 0.017). Two post-operative deaths occurred, both secondary to pulmonary emboli. Conclusions While the literature supports high patient satisfaction following surgery for AABP, complications are common. Adequate counseling, vigilant follow-up, and realistic expectations remain critical to the management of AABP. Based on our data and experience, all patients are now sent home on venous thromboembolism prophylaxis and surgical intervention is withheld until the patient’s BMI is less than or equal to 40 kg/m2. Disclosure No.