title: Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps.
abstract: OBJECTIVE
  To study scrotal microvascularization and apply the findings to the design of reliable skin flaps for reconstructive surgery of complex urethral or panurethral stenoses.
  
  
  METHODS
  In 15 cryopreserved male cadavers, scrotal skin vascularization was explored using macro- and microdissections, and the scrotal sac made transparent using the Spalteholtz method. A meticulous descriptive analysis of the arterial network was conducted out in all cases to evaluate the number, distribution and anastomosis of the cutaneous arteries of the scrotum.
  
  
  RESULTS
  Scrotal skin is irrigated by two main vascular systems, through the inferior external pudendal arteries and the perineal arteries, which branch into multiple scrotal arteries. These arteries are distributed in three cutaneous territories, two lateral and one central, which are widely inter-anastomosed. Each lateral territory receives an inferior external pudendal artery which accesses at the midpoint of the scrotal root and fans out to cover the entire corresponding hemiscrotum. The central cutaneous territory is vascularized through the branches of two main scrotal arteries which are a continuation of the perineal arteries and which access via the posterior face, running deeply on both sides of the septum.
  
  
  CONCLUSIONS
  The special anatomical distribution of scrotal branches stemming from perineal arteries enables the construction of adequate reliable longitudinal median island scrotal flaps for the reconstructive surgery of panurethral stenosis, as profuse axial vascularization is ensured.
authors.affiliation: Department of Human Anatomy, Faculty of Medicine, University of Barcelona, Barcelona, Spain. anna.carrera@udg.edu
authors.forename: Anna
authors.initials: A
authors.lastname: Carrera
authors.forename: Alfredo
authors.initials: A
authors.lastname: Gil-Vernet
authors.forename: Pau
authors.initials: P
authors.lastname: Forcada
authors.forename: Rosa
authors.initials: R
authors.lastname: Morro
authors.forename: Manuel
authors.initials: M
authors.lastname: Llusa
authors.forename: Octavio
authors.initials: O
authors.lastname: Arango
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D015925:Cryopreservation; D006801:Humans; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D012611:Scrotum / Q000098:blood supply* / Q000601:surgery / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply*; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*