Ectopic scrotum: Single stage rotational flap reconstruction with orchidopexy

Abstract

Congenital anomalies of the scrotum are rare; furthermore, ectopic scrotum and accessory scrotum are rarer still. We describe our series of four cases with their surgical management and long-term outcomes. We performed single stage rotational flap reconstruction with orchidopexy. Data was collected retrospectively for three cases of ectopic scrotum and one of accessory scrotum over the last twenty years in a tertiary paediatric surgery unit. Two infants with supra-inguinal ectopic scrotum underwent rotation pedicle flap procedure to relocate the scrotum and testis. The follow-up at 5 years shows excellent cosmetic outcome. The third infant had anorectal malformation and ectopic scrotum with absent testis. The fourth child had a large perineal hamartoma and an overlying accessory scrotum. In the later two, the empty scrotums were excised. Single stage rotational flap reconstruction with orchidopexy, is feasible and should be considered. It is a safe single stage technique to achieve excellent cosmesis and hopefully function of the ectopic gonad. Collaboration between paediatric surgeons and plastic surgeons in these rare cases is advisable. The published reports show cases operated in stages and at times sacrificing the ectopic scrotal skin. We elected to operate early without sacrificing scrotal tissue and preserving the testis.