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Objectives: We present the treatment of a patient with partial Adult-acquired buried penis (AABP) and extreme tissue retraction, complaining of genital skin tension and LUTS. Methods: Penile exteriorization was performed after circumcision. Glans mucosectomy was carried out because of suspicious glans mucosa. Ventral meatotomy was performed because of the stenotic meatus. For penile covering, we used scrotal skin for the shaft and skin mesh-graft for the glans. The scrotum was positioned around the penile shaft with a rotation flap. For the skin mesh graft we chose as donator the anterior thigh. Harvesting with a scalpel was preferred, so closure by primary intention was possible. We did not use the dermatome considering the low general self-care of the patient and the likely inadequate management of the wound with subsequent risk of infection or dysfunctional scarring. For the same reason we decided to use the smallest graft possible and to mesh it, to allow a better attachment and prevent hematoma or seroma under the graft. After the surgery the medication was sutured to the penis and maintained for one week, afterwards medications were performed 2 times per week for 21 days. Results: The operation lasted 165 minutes. No complications occurred intraoperatively. Stretched penis measured 7cm before surgery and 14cm after. At the first medication there was scrotum necrosis with wound dehiscence, it was removed entirely and exudative material covering the graft was cleaned. At successive medications, the genitals showed good healing process and minimum scarring of the mesh-graft. The patient referred good urinary function and aesthetic satisfaction without genital discomfort. Conclusions: For AABP at risk of non-optimal management of the wound after the operation, tissues with good attachment proprieties like scrotum and mesh-grafts can be safely used with good functional results. Conflicts of Interest: none [ABSTRACT FROM AUTHOR]

Objectives: In the last years a new generation of temporary urethral stent was designed. We report complications and outcomes from the largest case history available of self-expandable, metallic, PTFA-covered urethral stents with anti-migration flaps. Methods: 225 patients that underwent urethrotomy with Uventa stent placement between April 2016 and August 2021 in 7 different centers were included. Indication was patient preference as a first surgical approach or failed urethroplasty not willing to undergo a second invasive surgery. Surgical success was defined as absence of strictures requiring further treatments. The outcomes measured were complications during the stent indwelling time and treatment success. Results: The stricture was located at a proximal bulbar level in 190 patients, distal bulbar in 29 and penile in 6. Median follow-up was 37.9m. 109 (48.4%) patients had at least 1 complication, the figure shows the percentage distribution. Low flow (LF) after stent placement (17, 7.6%) was reported in a significantly higher proportion in penile strictures (2/6, p=0.025). Proximal bulbar strictures had a higher number of per-patient complications (p=0.024). 23 patients (12.9%) underwent early stent removal (ER, before 6m), of these 20 stents were dislocated. ER was more likely in penile strictures (3/6, p=0.047). LF and penile strictures were predictors of ER at univariable logistic regression (p<0.001, p=0.017). Penile stricture was also predictor of LF occurrence (p=0.034). 32/150 (21.3%) experienced treatment failure. Kaplan-Meier estimates by LF occurrence were significantly different (cumulative treatment success: 80.4% vs 42.8%; p=0.011) and Cox regression HR was 3.4 (p=0.022). Conclusions: Urethrotomy with Uventa placement is a feasible treatment for simple strictures. A detailed discussion about complications, with particular attention to stent displacement, and expectations should be carried out. LF after placement is suggestive of a subsequent ER and treatment failure. Penile strictures should not undergo urethral stent placement considering the association with ER and LF. Conflicts of Interest: None. [ABSTRACT FROM AUTHOR]