Objective

 To outline our step-by-step surgical technique using a sub-coronal buccal mucosal graft (BMG) resurfacing technique for the treatment of recurrent penile adhesions.

Methods

To perform the “Buccal Belt” procedure a sub-coronal circumferential segment of diseased skin was excised. An appropriately-sized buccal mucosal graft was circumferentially secured sub-coronally with a proximal and distal anastomosis to the edges of the wound. Quilting stitches were also placed to allow for proper graft fixation. A petroleum jelly bolster was secured as a tie-over dressing. Patients were discharged with a foley catheter and the bolster dressing in place. The bolster and foley catheter were removed 7 days postoperatively. They were then seen for follow-up at 4-to-6-month intervals.

A retrospective, international multi-institutional review was conducted to include all patients who underwent this procedure. Surgical complications, evidence of recurrence, and patient-reported outcome measures including Visual Analog Scale (VAS) and Global Response Assessment (GRA) questionnaires were reviewed.

Results

 Thirty-one men underwent the procedure across six institutions between 3/2014 and 9/2020. Mean surgical time was 59(25-95) minutes. At the mean follow-up of 27(4-79) months all patients reported resolution of presenting symptoms and no recurrence of adhesions. Mean VAS was 8.9 and 9.0 for aesthetics and functional outcomes respectively. On GRA overall improvement was reported by all patients (61% +3; 25% +2; 14% +1).

Conclusion

 There are limited options for the treatment of recurrent penile adhesions. A sub-coronal BMG resurfacing is feasible, with no recurrence and overall high satisfaction seen on an initial patient cohort.