What are the benefits and harms of surgical management options for adult‐acquired buried penis? A systematic review
Bibliographic record
Abstract
Objectives To systematically review the literature to determine the benefits and harms of the surgical techniques used for the correction of adult‐acquired buried penis (AABP). Materials and methods The systematic review was registered in the PROSPERO database (CRD42021267440) and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. The Pariser system was used to classify surgical procedures. Results In total, 170 studies were identified and screened, and 21 studies (570 patients) were included. In general, high‐complexity reconstructive procedures (category > III) were performed, with split‐thickness skin grafts for shaft reconstruction. The pooled mean operating time was 192.2 min and the mean estimated blood loss range was 57–326 mL. No intra‐operative complications were recorded. The incidence of postoperative complications varied across studies (0–80.8%), with >Grade 4 complications reported in 3.1–3.7% of cases. Wound infection and genital lymphoedema were reported in 4.7–33% and 7.1–60% of cases, respectively. The incidence of graft contracture and partial/total loss was 2.4–14.3% and 1.5–21%, respectively. The incidence of recurrence was not systematically reported and ranged from 5.2% to 13%. Postoperative evaluation of functional outcomes demonstrated significant improvements in sexual function, urinary function and cosmesis. Assessment of risk of bias demonstrated a high risk of bias across all studies. Conclusions Surgical management of AABP has a high incidence of complications but results in satisfactory outcomes, with significant improvement in patients' quality of life. The high incidence of graft‐related complications should be taken into account when counselling patients and AABP care should be centralized to high‐volume centres.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.047 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".