Scrotum & Penile Skin Reconstruction
Loss of penile skin and scrotum may be consequence of necrotizing fascitis, severe infections, trauma and accidents.
Loss of penile skin and scrotum may be consequence of necrotizing fascitis, severe infections, trauma and accidents. The reconstructive procedure should be able to provide a near normal scrotum and penile skin and be predictably reproducible without functional loss in the donor area and leave the patient with minimal deformity and scarring.
Cause of concern in scrotum and penile skin reconstruction
- The primary concern while repairing scrotal defects is protection of testes in order to prevent damage to the production of sperm. Testicular insult can be initially minimized with the use of wet dressing; alternatively, the testes can be temporarily positioned in subcutaneous thigh pouches. Although thigh pouches represent a good short-term solution, men do have pain, psychological issues and sperm count is significantly abnormal after 2 years in patients with testicles buried in thigh pouches and therefore, thigh pouches are not recommended as a long-term solution in patients who wish to preserve fertility.
- The prime concern while repairing penile skin to preserve the erectile function of the penis. Any method of reconstruction which hampers or makes the intercourse difficult should be avoided.
Technique of scrotum and penile skin Reconstruction
Penile Skin
- The penile skin can be primary closed by local tissue arrangement and techniques, if the loss of penile skin is up to 30 - 40 percent
- The penile skin can readily be grafted by taking split thickness skin graft from the thigh.
- Local flaps from groin/pubic area/prepuce
Scrotum
- The laxity of the scrotal skin allows for primary closure even in skin losses of up to 60 percent.
- When primary closure is not possible, reconstruction of the scrotum and penile skin can be achieved using skin graft. Adequate preparation of the recipient site for grafting is paramount in order to achieve an adequate cosmetic and functional result. The spermatic cord and testicles should be sutured together along the midline to minimize the grafting area and to prevent the creation of a double scrotum.
- Meshed grafts are a good solution for scrotal repair, since they allow the drainage of exudate through the fenestrations, thus improving the success of graft take to nearly 100%. Moreover, when healed, they mimic the rugae that normally characterize the scrotal skin.
- Local flaps from thigh, perineum
Disadvantage of skin grafting on scrotum and penis
Skin Grafts are-
- sensationless,
- demand a long and time-consuming period of wound care,
- play no role in the thermoregulation of the scrotal content
- when grafted over penis, the grafted skin can contract and cause difficulty on erection.
- Patchy area of graft loss over penis can lead to unstable areas of skin and frequent pain and bleeding
Therefore, local pedicled flaps are the preferred option for providing testicular and penile skin coverage, when the remnant scrotal/penile skin is insufficient for primary closure.
Advantage of flap over graft on scrotum and penis
The use of local flaps is not associated with the typical complications of skin grafts such as skin maceration, poor take and breakdown secondary to faecal and urinary contamination and requires less intense postoperative care.
Various muscle-skin and skin flaps based on tissue from the perineum, groin, pubic region and thigh can be taken to reconstruct scrotal and penile skin.
Scrotal reconstruction can be done by means of two transposition flaps taken from the thighs. The created scrotal sac is inserted with silicone testicular implants if testes are absent.
Among other flaps, the medial circumflex femoral artery perforator flap, the gracilis myofasciocutaneous flap, the neurovascular pedicled pudendal thigh flap and the Singapore flap are the most commonly used.
Shaping dreams through
Know your surgeon better
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
His Credentials
Three pillars of kayakriti
Privacy
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Trust
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
Safety
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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