Scrotal Reconstruction Using Thigh Pedicle Flaps: Long- Term Follow-up of 12 Cases
WACHIRA KOCHAKARN,M.D.*, PRASART HOTRAPA WANOND, M.D.**
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ** Noparat Rajthanee General Hospital, Department of Medical Services, Ministry of Public Health, Bangkok 10230, Thailand.
Introduction: Genital skin loss in men may be caused by avulsion injuries of the penis and
scrotum or by gangrene of the male genitalia. Reconstruction of the scrotum after complete loss of
the overlying skin is a challenging problem. We report our experience on the management of this
problem.
Materials and Methods : Medical records of all male patients with massive scrotal skin loss
and exposed testes treated at Ramathibodi Hospital and Noparat Rajthanee Hospital from 1990 to
1999 were reviewed. The etiologies of scrotal skin loss, technique of treatment, post-operative conse-
quence as well as complications were noted.
Results : Twelve patients were described in this study. Nine patients had avulsion injuries
of the penile and scrotal skin secondary to agricultural machinery accidents. Three patients were
after extensive debridement of Fournieris gangrene. The exposed testes had been placed in thigh
pouches and scrotal reconstruction using thigh pedicle flaps was done 4-6 weeks later. No imme-
diate and delayed complications were detected in all of the patients. They recovered without any
sequelae and had a satisfactory cosmetic result.
Conclusion : Extensive scrotal skin loss should be immediately treated surgically. Implanta-
tion of the exposed testes in the upper thigh pouch and delayed reconstruction of the scrotum using
thigh pedicle flaps can provide excellent results
Keywords : Genital Skin Loss, Scrotal Reconstruction, Thigh Pedicle Aap
