Clinical Validation of an Adult Acquired Buried Penis (AABP) Classification System Based on Standardized Evaluation of the Penis (P), Abdomen (A) and Scrotum (S)

Charles H Schlaepfer; Kevin J Flynn; Nejd F Alsikafi; Benjamin N Breyer; Joshua A Broghammer; Jill C Buckley; Sean P Elliott; Jeremy B Myers; Alex J Vanni; Bryan B Voelzke; Lee C Zhao; Bradley A Erickson

doi:10.1016/j.urology.2023.04.048

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Clinical Validation of an Adult Acquired Buried Penis (AABP) Classification System Based on Standardized Evaluation of the Penis (P), Abdomen (A) and Scrotum (S)

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Clinical Validation of an Adult Acquired Buried Penis (AABP) Classification System Based on Standardized Evaluation of the Penis (P), Abdomen (A) and Scrotum (S)

Charles H Schlaepfer, Kevin J Flynn, Nejd F Alsikafi, Benjamin N Breyer, Joshua A Broghammer, Jill C Buckley, Sean P Elliott, Jeremy B Myers, Alex J Vanni, Bryan B Voelzke, …

Urology (Ridgewood, N.J.), Vol.180, pp.249-256

10/2023

DOI: 10.1016/j.urology.2023.04.048

PMID: 37507025

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https://escholarship.org/content/qt3xx0339n/qt3xx0339n.pdf?t=sk9vtfView

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Abstract

Objective To clinically validate a previously developed adult acquired buried penis (AABP) classification system that is based on a standardized pre-operative physical exam that subtypes patients by their penile skin/escutcheon complex (P), abdominal pannus (A) and scrotal skin (S). Methods The Trauma and Urologic Reconstruction Network of Surgeons (TURNS) database was used to create an AABP cohort. Patients were retrospectively classified using the previously described PAS classification system. The frequency of subtypes, surgical methods utilized for AABP repair, and correlations between PAS classification and surgery subtypes were analyzed. Results The final cohort consisted of 101 patients from 10 institutions. Interrater reliability between two reviewers was excellent (κ=0.95). The most common subtypes were P2c (contributory escutcheon + insufficient penile skin; 27%) and P2a (contributory escutcheon + sufficient penile skin; 21%) for penile subtypes, A0 (no pannus; 41%) and A1 (non-contributory pannus; 39%) for abdominal subtypes, and S0 (normal scrotal skin with preserved scrotal sulcus; 71%) for scrotal subtypes. AABP repair procedures included escutcheonectomy (n=59, 55%), scrotoplasty (n=51, 48%), split-thickness skin grafting (n=50, 47%), penile skin excision (n=47, 44%) and panniculectomy (n=7, 7%). P, A and S subtypes were strongly associated with specific AABP surgical techniques. Conclusion The PAS classification schema adequately describes AABP heterogeneity, is reproducible amongst observers, and correlates well with AABP surgery types. Future work will focus on how PAS subtypes affect both surgical and patient-centered outcomes.

Classification

Escutcheon

Adult-Acquired Buried Penis

Phimosis

Details

Title: Subtitle: Clinical Validation of an Adult Acquired Buried Penis (AABP) Classification System Based on Standardized Evaluation of the Penis (P), Abdomen (A) and Scrotum (S)
Creators: Charles H Schlaepfer - University of Iowa
Kevin J Flynn - University of Iowa
Nejd F Alsikafi - UroPartners, Gurnee, IL, USA
Benjamin N Breyer - University of California, San Francisco
Joshua A Broghammer - University of Kansas
Jill C Buckley - University of California San Diego
Sean P Elliott - University of Minnesota
Jeremy B Myers - University of Utah
Alex J Vanni - Lahey Institute of Urology, Burlington, MA, USA
Bryan B Voelzke - Spokane Urology, Spokane, WA, USA
Lee C Zhao - New York University, New York City, NY, USA
Bradley A Erickson - University of Iowa, Iowa City, IA, USA. Electronic address: brad-erickson@uiowa.edu
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.180, pp.249-256
DOI: 10.1016/j.urology.2023.04.048
PMID: 37507025
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Language: English
Electronic publication date: 07/26/2023
Date published: 10/2023
Academic Unit: Urology
Record Identifier: 9984455489602771

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