Claudio Thomas1, Alfonso Navia2. 1. Clínica Thomas, Santiago, Chile. 2. Section of Plastic and Reconstructive Surgery, Surgery Division, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile. ajnavia@uc.cl.
Abstract
BACKGROUND: Increased scrotal laxity is a poorly defined entity often associated with discomfort while wearing loose clothes, walking, doing sports and during intercourse. In our experience, this condition is produced by an enlarged scrotal bag hanging more than 1-2 cm below the tip of the penis and can be associated with persistent penoscrotal webbing. Our objective was to perform a systematic literature review addressing the diversity of this entity and its surgical treatment, as well as propose a diagnostic and therapeutic approach. METHODS: A systematic search strategy was performed following PRISMA guidelines under the terms: Scrotum(Mesh), Plastic Surgery(Mesh), Reduction Surgery, Scrotoplasty, Ventral Phalloplasty, Scrotomegaly, Penoscrotal Web, Webbed Penis(Mesh), Scrotal Lifting, Scrotopexy and Scrotal Tuck. Articles referring to scrotum reduction or plasty in male genital rejuvenation context and ventral phalloplasty related to adult penoscrotal webbing correction were considered eligible for analysis. A management algorithm and surgical technique is proposed along with the results. RESULTS: A total of 1430 articles were found. After removing duplicates and applying inclusion and exclusion criteria, 11 articles were eligible for analysis. Most articles corresponded to case reports or surgical technique descriptions. Based on correcting excessive scrotal skin and/or penoscrotal webbing, we propose a vertical midline scrotal skin resection and a penoscrotal junction Z plasty, respectively. CONCLUSIONS: Aesthetic scrotoplasty and scrotal rejuvenation surgical techniques still remain as entities poorly addressed in the international literature. More reported experiences are needed in order to complement our proposed management algorithm and develop a nomenclature, diagnostic and treatment consensus. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 . Genital Surgery.
BACKGROUND: Increased scrotal laxity is a poorly defined entity often associated with discomfort while wearing loose clothes, walking, doing sports and during intercourse. In our experience, this condition is produced by an enlarged scrotal bag hanging more than 1-2 cm below the tip of the penis and can be associated with persistent penoscrotal webbing. Our objective was to perform a systematic literature review addressing the diversity of this entity and its surgical treatment, as well as propose a diagnostic and therapeutic approach. METHODS: A systematic search strategy was performed following PRISMA guidelines under the terms: Scrotum(Mesh), Plastic Surgery(Mesh), Reduction Surgery, Scrotoplasty, Ventral Phalloplasty, Scrotomegaly, Penoscrotal Web, Webbed Penis(Mesh), Scrotal Lifting, Scrotopexy and Scrotal Tuck. Articles referring to scrotum reduction or plasty in male genital rejuvenation context and ventral phalloplasty related to adult penoscrotal webbing correction were considered eligible for analysis. A management algorithm and surgical technique is proposed along with the results. RESULTS: A total of 1430 articles were found. After removing duplicates and applying inclusion and exclusion criteria, 11 articles were eligible for analysis. Most articles corresponded to case reports or surgical technique descriptions. Based on correcting excessive scrotal skin and/or penoscrotal webbing, we propose a vertical midline scrotal skin resection and a penoscrotal junction Z plasty, respectively. CONCLUSIONS: Aesthetic scrotoplasty and scrotal rejuvenation surgical techniques still remain as entities poorly addressed in the international literature. More reported experiences are needed in order to complement our proposed management algorithm and develop a nomenclature, diagnostic and treatment consensus. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 . Genital Surgery.
Entities:
Keywords:
Aesthetic scrotoplasty; Scrotal lifting; Scrotomegaly; Scrotopexy; Scrotum reduction surgery
Authors: Carlo Bettocchi; Andrea Alberto Checchia; Ugo Giovanni Falagario; Anna Ricapito; Gian Maria Busetto; Luigi Cormio; Giuseppe Carrieri Journal: Int J Impot Res Date: 2022-04-05 Impact factor: 2.408