Total scrotal reconstruction with vertical rectus abdominis musculocutaneous (VRAM) flap in the treatment of penoscrotal lymphedema

Abstract

A 37-year-old man with scrotal and penile lymphedema was treated by total excision of the scrotal and penile skin and subcutaneous tissue. Split thickness skin grafts were used to cover the penis and the pubic area. An inferiorly based left rectus abdominis muscle with a 12 x 16 cm skin island from the epigastric region was used to reconstruct the scrotum. The VRAM flap is a simple, reliable flap and it provides sufficient coverage of the exposed testicles after total excision of diseased scrotal skin. It also gives a satisfactory esthetic result. The VRAM flap may be another source for reconstruction of the total scrotum.