Ep. 319 Reconstructive Techniques for Adult Buried Penis with Dr. Paul Rusilko

The definitive treatment for adult acquired buried penis is surgery, but successful treatment depends on having a well-coordinated network of patient support, multidisciplinary care teams, and reconstructive urologic surgery expertise. This episode of Backtable Urology overviews this multifaceted disease and dives into reconstructive surgery techniques, featuring Dr. George Koch and Dr. Paul Rusilko. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:10 - History of Buried Penis Treatment 08:47 - Grafts Versus Flaps 11:34 - Hidden Pathologies and Informed Consent 13:46 - Research and Insurance Approval 18:24 - Delayed Care and Disease Burden 22:31 - Deciding When to Operate and Temporizing Procedures 30:23 - Building Referral Networks 33:13 - Future Directions 36:42 - Infection Risk 41:15 - Technique Evolution 45:57 - Preop Evaluation Essentials 50:50 - Intraop Keys to Success and Graft Protection 59:26 - Postop Pathway and Teamwork 01:02:54 - W-Plasty Video Walkthrough 01:13:52 - Wrap Up --- More about this episode The doctors explore the nuances of surgical treatment, emphasizing the importance of thorough preoperative counseling given the high likelihood of unexpected intraoperative findings and the need to adjust the surgical plan. Dr. Rusilko also discusses the broader burden of disease, including depression, strictures, occult penile cancer, and the high rate of postoperative complications, most of which are low grade. He stresses that earlier referral may improve patient care. The episode concludes with practical surgical tips, guidance on building a buried penis practice, strategies for setting realistic recovery expectations, and an in-depth case review of his novel W-plasty technique. --- Resources W-plasty: A novel procedure for the repair of adult-acquired buried penis https://doi.org/10.1016/j.urolvj.2023.100219 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app