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Staged male genital reconstruction with a local flap and free oral graft: a case report and literature review

Authors
  • Zheng, Da-chao1
  • Xie, Min-kai1
  • Fu, Shi-bo1
  • Guo, Jian-hua1
  • Li, Wen-ji1
  • Yao, Hai-jun1
  • Wang, Zhong1
  • 1 Shanghai JiaoTong University School of Medicine, Department of Urology, Shanghai 9th People’s Hospital, NO.369, ZhiZaoJu Road, HuangPu District, Shanghai, 200011, China , Shanghai (China)
Type
Published Article
Journal
BMC Urology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 29, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12894-019-0537-6
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundMale genital skin loss is a common disease in urology. However, male genital skin loss accompanying a penile urethra defect is rarely reported. Herein, we describe a novel surgical technique using a composite local flap and oral mucosal graft to reconstruct the penis, which may provide a new solution for patients with similar conditions.Case presentationA 36-year-old male with a penile urethra defect and a large area of genital skin loss required urethral reconstruction. The meatus had descended to the penoscrotal junction. This procedure was divided into three stages. The first stage of the surgery involved burying the nude penile shaft beneath the skin of the left anteromedial thigh for coverage of the skin defect. The second stage consisted of releasing the penis and expanding the size of the urethral plate for further urethroplasty. The third stage consisted of reconstruction of the anterior urethra 6 months later. Postoperatively, the patient reported satisfactory voiding. The maximal flow rate (MFR) was 22.2 ml/s with no postvoiding residual urine at the 24-month follow-up visit. No edema, infection, hemorrhage, or cicatricial retraction were observed. The patient’s erectile function was satisfactory, and his international index of erectile function-5 score (IIEF-5 score) was 23 at the 24-month follow-up visit. Additionally, the presence of nocturnal penile tumescence demonstrated that he had normal erectile function.ConclusionsThis procedure is an effective surgical option for men with complete foreskin and penile urethra defects. It could also be extended as a treatment strategy when composite local or pedicle transposition flaps and free grafts are needed for specific patients.

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