Investig Clin Urol.  2019 Mar;60(2):133-137. 10.4111/icu.2019.60.2.133.

Penile skin preservation technique for reconstruction surgery of penile paraffinoma

• Kim JS
• Shin YS
• Park JK

• KMID: 2438825
• DOI: http://doi.org/10.4111/icu.2019.60.2.133

Abstract

PURPOSE
Penile resurfacing with various scrotal flaps is a simple, effective, and reliable reconstructive armamentarium to treat penile paraffinoma. However, scrotal flaps often result in heavy hair-bearing penile skin causing dyspareunia or shortening of penile length. We introduce a new penile skin preservation technique for reconstruction surgery of penile paraffinoma.
MATERIALS AND METHODS
From March 2007 to April 2018, 23 patients underwent excision of paraffinoma with the penile skin preservation technique. Complete removal of the subcutaneous tissue was done, including paraffinoma. No. 10 surgical blades were used to peel off the skin as thin as possible in order to get paraffinoma-free skin. The preserved penile skin was given an end to end anastomosis to the circumferential incision site. Multiple anchoring fixation sutures of the penile skin were made on the underlying tissue. Dressing of chopped gauze soaked with antibiotic saline solution was done on the skin to help preserve it and keep it fixed on the penis.
RESULTS
The skin survived completely without necrosis in 19 patients (82.6%), with the mean duration of healing being 21.9 days. The penis after the operation looked natural in color and shape. Partial necrosis after the operation was shown on 4 patients (17.4%), whom were all later treated with the scrotal skin free graft. The final results were successful without any cosmetic or functional complications, such as skin contracture.
CONCLUSIONS
Penile resurfacing with the penile skin preservation technique is a new effective reliable method for skin-intact paraffinoma which produces good functional and cosmetic results.

Keyword

Foreign bodies; Penis; Reconstructive surgical procedures; Skin

MeSH Terms

Bandages
Contracture
Dyspareunia
Female
Foreign Bodies
Humans
Male
Methods
Necrosis
Penis
Reconstructive Surgical Procedures
Skin*
Sodium Chloride
Subcutaneous Tissue
Sutures
Transplants
Sodium Chloride

Figure

• 

  Fig. 1 Schematic view of operative stages. (A) Penile deformity due to penile paraffinoma. (B) Peel off the skin as thin as possible in order to get paraffinoma free skin. (C) Complete removal of paraffin. (D) Multiple anchoring fixation sutures between the penile skin and penile bed was done. (E) The penile skins survived completely without skin contracture.

• 

  Fig. 2 A 2 months after penile resurfacing with the penile skin preservation technique. (A) Dorsal side. (B) Ventral side.

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