Abstract
Reconstructing a penile stump secondary to trauma or cancer should result in satisfactory penile function and appearance. The lack of penile skin, stump retraction in the scrotum and stenosis of the neomeatus must be resolved in these cases. A 2-stage surgical technique with a scrotal flap was used in 34 patients with a mean age of 43.2 years to reconstruct the glans. Mean followup was 73.2 months. After penectomy a scrotal flap was designed and its distal extreme was transferred to the penile stump. The urethral end was sutured to a hole in the scrotal flap and the flap borders were sutured to the adjacent albuginea. The flap pedicle was resected 4 to 6 weeks later. Patient recovery was characterized by a normal-appearing penis and unobstructed urinary flow. Definite depilation of the neoglans was required in 17.6% of cases. Partial necrosis of 2 flaps (5.8%) required grafts. Sexual potency was preserved in 7 men (20.5%). In 1 case (2.9%) urethral meatal stenosis resolved with minor surgical procedures. This technique enables us to design a neoglans with acceptable function and appearance, no penile retraction, satisfactory voiding and in certain cases possible intercourse with vaginal penetration.
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