Scrotal Tissues: The Perfect Material for Urogenital Reconstruction

Abstract

Background: Correction of male urogenital pathology of different severity is complicated by the anatomical aspects of the penis. Skin texture, internal structures, and perfusion dynamics of the urogenital area make it a difficult area to reconstruct. We provide our experience with axial scrotal flaps for correction of penile defects of different severity and believe that these local flaps offer sufficient tissue characteristics for proper restoration of this complex region. Methods: Forty-eight patients were divided into 3 groups depending on penile defect genesis and severity. Axial scrotal flap reconstruction was used for the correction of defects in all cases, when necessary in combination with other flaps. Results: Axial scrotal flaps for total and subtotal penile reconstruction serve as valuable material for reconstruction of the urogenital area, and are to be combined with other flaps for restoration of bulk tissues. Localized defects of the penis and urethra reconstructed by axial scrotal flaps provide excellent aesthetic results with minimal scaring, stable perfusion dynamics, and high satisfaction rate. Conclusions: Scrotal tissues provide an excellent reconstruction material for penile defects because of their highly similar tissue structure as that of the penis. Scrotal axial flaps do not provide excess bulking in the postoperative period and are recommended for reconstruction of urethral and localized penile defects. Multistage surgery is recommended in cases of severe tissue damage, in combination with other flaps (inguinal, thoracodorsal, and radial).

Alternative surgical management of penile siliconoma using partial degloving and resurfacing

“…The goal of any of these reconstructive surgery techniques is to retrieve penis functionality and aspect. The scrotal flaps provide high aesthetic results and postoperative satisfaction with high flap viability, and they can be used for the treatment of various urogenital defects, regardless of its severity (11). Surgical methods of this technique range from single-sided scrotal axial flap for defect closure to a combination of multistage stacked flap methods; scrotal axial flaps always requires an intact donor site and they are often used for patients with defects due to penile enhancement injections (11).…”

“…The scrotal flaps provide high aesthetic results and postoperative satisfaction with high flap viability, and they can be used for the treatment of various urogenital defects, regardless of its severity (11). Surgical methods of this technique range from single-sided scrotal axial flap for defect closure to a combination of multistage stacked flap methods; scrotal axial flaps always requires an intact donor site and they are often used for patients with defects due to penile enhancement injections (11). STSG is an easy and effective technique capable of covering large surfaces of skin loss, and at the same time provide excellent functional and aesthetic outcomes (12).…”

A New Modified Bipedicle Scrotal Skin Flap Technique for the Reconstruction of Penile Skin in Patients with Paraffin-Induced Sclerosing Lipogranuloma of the Penis

“…Its advantages include easy accessibility, mobility, rich vascularity, and similarity to penile skin regarding color, elasticity, and tactile and erogenous sensations. 19,20 The drawbacks of scrotal skin flaps are hairy skin and their limited size, which can be particularly important issues in SLP with scrotal involvement. Two-stage scrotal skin flap reconstruction consists of denuded penile shaft embedment into the scrotum in the first stage, followed by liberation of the penis from the scrotum in the second stage.…”

Reconstructive Surgery for High-voltage Injury of Genitoperineal Area and Upper Extremities: The Uromanual Trauma Concept

“…Despite this, scrotal tissues provide excellent elasticity and viability, unlike full-thickness or split- thickness skin autografts. 24 , 25 …”

“…Despite this, scrotal tissues provide excellent elasticity and viability, unlike full-thickness or split-thickness skin autografts. 24,25 Cutaneous defects of the hands as a result of postburn cicatricial deformities can be restored by means of skin grafts. Reconstructive surgery on the upper extremities restores lost and damaged tissues, prevents post-traumatic infectious complications, and creates a reliable support function for subsequent exo-prosthetic limbs in cases of limb amputations.…”