Penopubic Junction Reconstruction Using a Pedicled Superficial Circumflex Iliac Artery Perforator Flap

Abstract

In surgical procedures involving the penopubic junction, there are significant risks associated with postoperative scar traction. Scar traction may result in a short penis and other deformities, which may cause discomfort during erections and interfere with the patient's sexual performance. The article describes the case of a 27-year-old male who had undergone a penis lengthening procedure four years earlier. After the surgery, the skin around the penopubic junction was scarred and became severely contracted. This led to a short penis and a high hanging scrotum as a consequence of the scarring. The purpose of this case report is to describe how we repaired the penopubic junction with a pedicled superficial circumflex iliac artery perforator flap. At the penopubic junction, there was a defect measuring 4 x 3 cm following the removal of the contracture scar. The affected region was repaired using a left pedicled modified superficial circumflex iliac artery perforator flap based on its medial superficial branch. Moreover, a hybrid technique was developed to harvest the superficial circumflex iliac artery perforator flap in a safe and effective manner. Using the hybrid technique, a proximal-to-distally flap elevation approach was combined with a pedicle elongation strategy to lengthen the pedicle. It is our experience that the pedicled superficial circumflex iliac artery perforator flap may provide an effective alternative method of reconstructing the postoperative scar traction at the penopubic junction.