الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The size of the Penis has been a source of anxiety for men throughout history, and if a man perceives his penis as inadequate, whether real or imagined, then this feelings invade his interaction with his social associates and sexual partners. Thus, men often feel a need to enlarge their penises in order to either satisfy and/or impress their partners or improve their selfesteem. A buried penis refers to a normal sized phallus encompassed in the prepubic area by either skin, subcutaneous tissue, and/or fat. Because of reduction of the apparent and functional length of phallus, this condition is often associated with patient dissatisfaction related to hygienic, cosmetic, voiding, and sexual dysfunction. Furthermore, the Subsequent phimosis can result in urinary soilage, spraying, dribbling and skin break down. Weight loss may improve some symptoms for those who have a buried penis secondary to obesity, however many men have significant remaining prepubic fat deposition along with ptosis of the prepubic fat pad, or escutcheon, that would need surgical intervention. Several surgical techniques, including infrapubic liposuction, suprapubic lipoectomy, dermato-lipoectomy, correction of scrotal web and grafting, have been attempted in treating of buried penis. The basic intent of these procedures is to extract the penis from the pubic fat pad (escutcheon) or scars and fix the phallus to the structures, such as the pubic symphysis, for more durable morphological and functional recovery. The aim of the present study was to evaluate the surgical and functional outcome of penile lengthening techniques with or without suspensory ligament release in the management of adult buried penis. This prospective randomized study was carried out in Urology Department Tanta University Hospital in the period from October 2020 to February 2023. It included 68 adult obese patients with clear demarcation between Escutcheon and pannus. Eight patients were lost during follow up 6 cases in group A and 2 cases in group B. Patients were randomly divided into two groups: group (A) (include 28 cases underwent supra pubic dermatolipoectomy with suspensory ligament release) and group (B) include (32 cases underwent suprapubic liposuction without suspensory ligament release). In order to compare the results between suprapubic dermatolipectomy and liposuction we elected to include only cases of AABP with contributory escutcheon and sufficient penile skin (P2a & P2b in PAS classification (93) in absence of pannus (A0) and in absence of scrotal lymphedema (S0). All patients were subjected to the following: detailed medical history, physical examination, laboratory evaluation (complete blood picture, serum creatinine, liver function tests, prothrombin time and concentration and hormonal profile if indicated). The data collected including: Age, Body mass index BMI (Kg/m2), (pre and (on table and 6 months) postoperative penile length, operative time, hospital stay, intra and (immediate and late) post-operative complications) and patient satisfaction rate postoperative.