Current Concepts in Scrotal Reconstructive Surgery

Abstract

Scrotal reconstruction may be required in any setting where the patient sustains loss of a large area of scrotal or penile skin, as in repair of scrotal lymphedema and the adult acquired buried penis. Massive scrotal lymphedema and adult acquired buried penis are two conditions closely linked to obesity and are largely refractory to non-operative management. The demand for surgical repair of these conditions is increasing. The aim of this article is to provide an overview of the preoperative considerations, surgical techniques, and postoperative outcomes in the repair of scrotal lymphedema and adult buried penis. Scrotal lymphedema and adult buried penis are associated with significant medical comorbidities and can cause sexual and urinary dysfunction. Surgical repair requires a multidisciplinary approach. Skin grafts are often required. There is no consensus regarding optimal postoperative management of these surgical wounds. Consideration should be given to extended duration chemical prophylaxis of thromboembolic events. Though complications are common, patient quality of life is significantly improved following repair. The demand for surgical repairs of scrotal lymphedema and adult buried penis are increasing. Though patients have significant comorbidities and surgical repair may be complex, patient outcomes are good and quality of life can be greatly improved.