(807) Outcomes of Adult Acquired Buried Penis Reconstruction: A Multicentre Cohort Study

Introduction We present a case of penile reconstruction for advanced AABP (Acquired Buried Penis) caused by a sclerosing granuloma secondary to self-injection of mineral oil. AABP is a morbid condition often requiring surgical intervention. Objective This study aims to provide a detailed analysis of outcomes after surgical correction of AABP. Methods This multicentre retrospective study, the largest of its kind in Europe to date, evaluated outcomes of 204 patients who underwent AABP repair between June 2011 and January 2025 evaluates surgical and functional outcomes (urinary and sexual), and patientreported outcomes. AABP repairs were classified according to surgical complexity following Santucci's classification. The primary endpoint of the study was the recurrence-free rate (RFR) survival at 12 and 24 months follow-up. The secondary endpoints were surgical, functional and patients' reported outcomes (PROs). The International Index of Erectile Function (IIEF-15) and the International Prostate Symptoms Score (IPSS) were used to assess patients' erectile and urinary function in pre and postoperative settings. Results The median follow-up of 18 months(IQR 7.0–46.0). Surgical complexity was classified according to the Pariser system; 70.6% underwent high-complexity procedures (Pariser≥III). Obesity (BM≥30kg/m2) was the leading etiological factor(45.1%), more prevalent in the high-complexity group (p<0.001), followed by lichen sclerosus(23.0%), more prevalent in low-complexity group (p=0.011), and genital lymphoedema(20.1%). Main presenting complaints included sexual dysfunction(50.5%), aesthetic concerns(40.7%), and urinary problems(36.3%). Skin grafts were used in 44.6% of cases, more often in low-complexity procedures (p<0.001). The overall complication rate was 27.0%, significantly higher in the high-complexity group (32.6% vs. 13.3%, p=0.005), with high-complexity surgery independently predicting complications (p=0.013). Recurrence occurred in 12.7%, with recurrence-free survival of 91.5% and 83.7% at 12 and 24 months, respectively. Hematoma(p<0.001) was associated with an increased risk of recurrence, whereas higher surgical complexity(p=0.018) was associated with a reduced risk of recurrence. Postoperative gains included an increase in stretched penile length by 3 cm, improved urinary and sexual function(p<0.001), and high satisfaction rates(86.8%). Conclusions Although AABP surgery is complex and associated with a higher rate of early complications, it provides durable functional recovery, with a median gain in stretched penile length and significant improvements in urinary function, sexual satisfaction, and overall quality of life through a comprehensive, patient-tailored approach. Disclosure No