Evaluation and outcome of M plasty for the management of doughnut scrotum

Abstract

Introduction: Penoscrotal transposition is a rare anomaly of the external genitalia. They can be classified as complete or incomplete based on degrees of positional exchange between the penis and the scrotum. Both forms are known to be associated with hypospadias and multiple surgeries are required for complete correction. Most surgeries performed for the correction of penoscrotal transposition involve making a complete circular incision around the root of the scrotum, which often results in massive penile lymphoedema and often delays the correction of hypospadias. The M plasty technique can prevent the incidence of lymphoedema by preserving the dorsal penile skin. Objective: To evaluate the effectiveness of M plasty for the correction of penoscrotal transposition. Materials and methods: Sixteen patients underwent M plasty for incomplete penoscrotal transposition. An ‘M’-shaped incision was made at the base of the scrotum and the scrotal halves were dissected and brought down posterior and caudal to the penis and sutured primarily. Results: All patients showed excellent cosmetic results. There was minimal postoperative oedema with no vascular compromise to penile or scrotal skin. Conclusion: M plasty is an excellent technique for the correction of penoscrotal transposition. The low incidence of penile lymphoedema could be attributed to the preservation of the dorsal penile skin. This procedure provides an excellent cosmetic appearance and also allows for early correction of hypospadias.