title: Surgical management of genitoperineal hidradenitis suppurativa in men.
abstract: OBJECTIVE
  To report our successful experience in treating genital and perineal hidradenitis suppurativa (HS) and its sequelae including localized chronic lymphedema. We describe our method of diseased tissue resection and wound defect coverage with local flaps and split-thickness skin grafts (STSG).
  
  
  METHODS
  From 2004 to 2012, we treated 6 patients with genital and perineal HS with radical resection of diseased tissue. Wound coverage was performed with skin flaps and/or STSGs.
  
  
  RESULTS
  Two patients had enough normal neighboring skin for local flap coverage of their wound defect. Four others had more extensive disease requiring STSG coverage. Two patients with secondary penile skin lymphedema required STSG for penile shaft reconstruction. All patients achieved excellent cosmetic results. There was one recurrence that required repeat resection and wound coverage. No wound complications occurred at the STSG donor site. Successful STSG "take" on the scrotum and penis ranged from 90% to 100% (mean 98%). Wound complications from local flap closure were clinically insignificant and include small (≤2 cm) areas of wound breakdown with no evidence of infection in 3 patients (50%).
  
  
  CONCLUSIONS
  Genitoperineal HS is a debilitating and disfiguring disease that results in the need for repeated abscess drainage operations, chronically painful skin boils, and chronic foul-smelling infectious discharge. It can be associated with lymphedema of surrounding tissues, requiring removal of tissues not originally affected by the disease. The use of complete resection and reconstruction with skin flaps and grafts provides a viable treatment option for these patients.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: chenml@upmc.edu.
authors.forename: Mang L
authors.initials: ML
authors.lastname: Chen
authors.affiliation: Department of Urology, Detroit Medical Center, Michigan State College of Medicine, Detroit, MI.
authors.forename: Brian
authors.initials: B
authors.lastname: Odom
authors.affiliation: Department of Urology, Detroit Medical Center, Michigan State College of Medicine, Detroit, MI.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Santucci
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods*; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000175:diagnosis / Q000601:surgery*; D006084:Graft Rejection; D006085:Graft Survival; D017497:Hidradenitis Suppurativa / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D012611:Scrotum / Q000473:pathology / Q000601:surgery; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology