Scrotal bridge flap reconstructive surgery for extensive penile paraffinoma: steps and outcomes from a single center: a case series

Abstract

Background To describe our scrotal bridge flap technique in reconstructive surgery for extensive penile paraffinoma, a debilitating late complication of penile subcutaneous foreign material injection intended to achieve penile augmentation. Case presentation We reviewed the medical records of 10 patients who underwent reconstructive surgery with the scrotal bridge flap technique for penile paraffinoma at our center between 2016 and 2019. Complete excision of fibrotic tissue and the overlying skin was performed, and penile resurfacing was achieved by mobilizing the scrotal skin superiorly to wrap around the penile shaft, leaving a skin bridge at the median raphe. All 10 patients successfully underwent scrotal bridge flap penile reconstruction with satisfying results. The mean operation duration was 286.1 min (range 213–363 min). No immediate major complications were observed in any of the patients, and no patients required revision surgery. Conclusion The scrotal bridge flap technique is a reliable method for reconstructive surgery after the excision of penile paraffinoma.

Bilateral Technique of Penis Flap with Scrotum Skin in Penile Paraffinoma Cases: A Case Report

“…7,8 This technique was also selected because it showed better results in skin flexibility during erection, in the natural shape of the penis, in skin color similarity, and in its resistance during intercourse compared to doing a graft. 1,6 The disadvantage of doing a scrotal flap was that there was some hair on the scrotal skin which could interfere with the patient's comfort. 6 Besides, the devascularization of the penis skin is better on the skin that is not follicular, so complaints of dyspareunia frequently occur.…”

“…6 Besides, the devascularization of the penis skin is better on the skin that is not follicular, so complaints of dyspareunia frequently occur. 1,6 In several cases of one-step bilateral flaps, delays in wound healing were reported, resulting in necrosis of the skin, especially at the ends, due to poor blood vessel supply in the area and poor sanitation. 6 Comparison of efficiency and complication rates of various methods of penis reconstruction in cases of penile paraffinoma was difficult to describe due to limited study populations, and most publications were in the form of case reports.…”

“…Currently, paraffin is used as an injection material in the subcutaneous tissue of the penis to increase penis size. 1,2 paraffin or exogenous oil remains stable and semi-solid at room temperature but melts when it is warm. 3,4 The lack of enzymes in the human body to degrade paraffin causes various complications.…”