Archive for the Reconstructive Surgery

BIPEDICLED SCROTAL MYOCUTANEOUS FLAP: A NEW TECHNIQUE FOR AUGMENTATION PHALLOPLASTY

A. YOUSSEF, M. ESMAT AND M. WAEL
Department of Urology, Ain Shams University, Cairo, Egypt

Purpose: To assess efficiency and safety of our new technique of "bipedicled scrotal myocutaneous flap" in penile girth enhancement in cases of small penis syndrome.

Patients and methods: This study was conducted on 23 patients complaining of small penile size who did not respond to psychiatric treatment. Patients with ambiguous genitalia, hypospadias and epispadias were excluded from this study. All patients were subjected to penile augmentation using the new technique of bipedicled scrotal myocuanenous flap to increase penile circumference and division of suspensory ligament for penile lengthening. The change in penile dimensions was assessed by preoperative and postoperative measurement of stretched penile length (SPL) and mid penile girth. Follow up of the patients was done at 3 months and 9 months postoperatively.

Results: No intra-operative complications occurred. At 3 months postoperatively, the mean increase in penile dimensions was 2.3±0.2 (1.9-2.7) cm and 2.0±0.3 (1.6-3.1) cm in penile girth and penile length respectively. The patients' satisfaction rate was 65.2%. Only 3 cases experienced delayed scrotal wound healing that was managed conservatively without late sequelea. On follow up the penile girth enhancement was symmetrical and durable. No other postoperative complications reported. No affection of penile erection, significant scarring nor long term affection of penile sensation occurred.

Conclusion: The technique of bipedicled scrotal myocutanous flap is an easy and effective technique that provides a reasonable long term symmetrical increase in penile girth by using a well vascularised nearby flap. Moreover, it is a safe technique with no associated postoperative harmful sequelea.

 


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