Trans-scrotal penile degloving, a new procedure for corporoplasties
Urologia 2012; 79(3): 200 - 210
Article Type: SURGICAL TECHNIQUE
Edoardo Austoni, Vincenzo Maria Altieri, Raffaele Tenaglia
Introduction: The subcoronal approach is the most widely used skin degloving procedure for corporoplasty. Although it is relatively easy and it fully exposes the corpora cavernosa, it is not free from several complications (subcoronal lymphedema, decrease of glans sensitivity, paraphimosis, distal skin necrosis), which sometimes require a postoperative circumcision, or a preoperative prophylactic circumcision. Aim: To describe our own degloving approach, the "Trans-scrotal Penile Degloving (TPD)", that is suitable for most corporoplasties, and to present the outcomes. Methods: This is a retrospective analysis conducted on 89 patients (pts) presenting with different penile diseases, and submitted to the TPD during Corporoplasty, from February 2008 to July 2010: Congenital curvature (26 pts); Peyronie’s Disease (PD) with penile curvature (18 pts); PD with erectile dysfunction and curvature (25 pts); Redo surgery with complex tunica albuginea remodeling and prosthesis implant (20 pts). The TPD approach calls for a 5 cm incision to be placed ventrally on the scrotal raphe at the penile base: penile degloving is then easily carried out up to the coronal line. Subsequently, the dorsal neurovascular bundle is normally isolated and all types of different corporoplasties can be carried out. Results: Any complication occurring during or after surgery has been registered. Patient follow-up controls were performed on day 7, month 1 and month 3 post-surgery:
- No pre- or post-operative circumcision procedures were required;
- There was no evidence of post-operative preputial edema or penile skin necrosis or loss of glans sensitivity;
- In 6 patients, we noted a mild scrotal sub-dartos hematoma, which reabsorbed spontaneously.
Conclusions: TPD, which represents an evolution of our previous combined subcoronal-trans-scrotal approach, may be advantageously performed in most corporoplasties with optimal aesthetic and functional outcomes, and may replace in many cases the subcoronal approach without its associated complications.
- • Accepted on 20/02/2012
- • Available online on 12/04/2012
- • Published in print on 25/09/2012
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- Austoni, Edoardo
Cattedra di Urologia, Università di Milano - Italy
- Altieri, Vincenzo Maria
Centro di Uroandrologia Ricostruttiva, Ospedale Mangioni GVM (Lecco), Ospedale Salus GVM (Reggio Emilia), Ospedale Villalba GVM (Bologna) - Italy
- Tenaglia, Raffaele
Cattedra e Scuola di Urologia, Università di Chieti, Dipartimento di Urologia - Italy