Scrotal reconstruction using thigh pedicle flaps: long-term follow-up of 12 cases.

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. MATERIAL AND METHOD: 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 consequence 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 Fournierrís gangrene. The exposed testes had been placed in thigh pouches and scrotal reconstruction using thigh pedicle flaps was done 4-6 weeks later. No immediate 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. Implantation of the exposed testes in the upper thigh pouch and delayed reconstruction of the scrotum using thigh pedicle flaps can provide excellent results

Traumatic testicular dislocation a review of 36 cases.

We retrospectively reviewed 36 patients who were treated in our institutes with traumatic testicular dislocation from 1975 to 1997. The mean patient age was 25 years old (18-38). Average time to present at the emergency room was 1 hour (0.5-6). Bilateral dislocation was found in thirty cases and unilateral dislocation was found in six cases. The sites of dislocation included: 34 cases (64 testes) at superficial inguinal area, one case (one testis) at acetabular area, and one case (one testis) at the perineal area. Closed reduction under general anesthesia was successful in 14 cases, open reduction after failed closed reduction in 10 cases, open exploration and repaired testis with reposition in 11 cases and orchiectomy only in one case. The overall results after treatment showed the normal size and position of the testis.