Episode # 319 • 28 Jul 2026
Reconstructive Techniques for Adult Buried Penis
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.
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
Resources
You may also like
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.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.