Objective: To evaluate the feasibility and clinical efficacy of a scrotal skin flap in combination with penile lengthening for repairing penile defects.

Methods: From 1999 to 2008, 7 cases (19 to 42 years old) of penile defects were treated by scrotal skin flap in combination with penile lengthening. The average preoperative length of stubbed penis was 2.1 cm in flaccid (range: 1.0 to 3.0 cm) and 4.8 cm in erection (range: 3.0 to 5.5 cm). All cases were treated with penile elongation. And a bilateral scrotal skin flap supplied by anterior scrotal artery (n = 3) or whole anterior scrotum flap (n = 4) was used to cover the exposed penile shaft. The scrotal incision was sutured directly.

Results: There was no need for urethra reconstruction. It was simple to obtain the scrotal skin flap. And the operation might be quickly performed with a lesser hemorrhage as compared with penile reconstruction. The scrotal flaps survived without any necrosis and all wounds healed primarily with an excellent contour and erectile function. When followed up for 1 - 5 years, the average preoperative penile length was 6.4 cm in flaccid (range: 5.0 to 7.5 cm) and 9.5 cm in erection (range: 8.0 to 10.5 cm). All cases had normal functions of urination, erection and gonobolia. Five cases had satisfied sexual life and one experienced a sexual life.

Conclusions: The method of restoring partial penile defect with scrotal skin flaps is both simple and efficacious. Reasonable appearance and penile length are restored in most cases with better sensory and erectile functions.

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