title: Ventral Slit Scrotal Flap: A New Outpatient Surgical Option for Reconstruction of Adult Buried Penis Syndrome.
abstract: BACKGROUND
  We present a novel technique using ventral slit with scrotal skin flaps (VSSF) for the reconstruction of adult buried penis without skin grafting.
  
  
  METHODS
  An initial ventral slit is made in the phimotic ring, and the penis is exposed. To cover the defect in the ventral shaft skin, local flaps are created by making a ventral midline scrotal incision with horizontal relaxing incisions. The scrotal flaps are rotated to resurface the ventral shaft. Clinical data analyzed included preoperative diagnoses, length of stay, blood loss, and operative outcomes. Complications were also recorded. Fifteen consecutive patients with a penis trapped due to lichen sclerosus (LS) or phimosis underwent repair with VSSF. Each was treated in the outpatient setting with no perioperative complications. Mean age was 51 years (range, 26-75 years), and mean body mass index was 42.6 kg/m(2) (range, 29.8-53.9 kg/m(2)). The majority of patients (13 of 15, 87%) had a pathologic diagnosis of LS. Mean estimated blood loss was 57 cc (range, 25-200 cc), mean operative time was 83 minutes (range, 35-145 minutes), and all patients were discharged on the day of surgery. The majority of patients (11 of 15, 73.3%) remain satisfied with their results and have required no further intervention. Recurrences in 3 of 15 (20.0%) were due to LS, panniculus migration, and concealment by edematous groin tissue; 2 of these patients underwent subsequent successful skin grafting.
  
  
  CONCLUSIONS
  VSSF is a versatile, safe, and effective reconstructive option in appropriately selected patients with buried penis, which enables reconstruction of penile shaft skin defects without requiring complex skin grafting.
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Mary E
authors: ME
authors: Westerman
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Timothy J
authors: TJ
authors: Tausch
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Lee C
authors: LC
authors: Zhao
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Jordan A
authors: JA
authors: Siegel
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Nathan
authors: N
authors: Starke
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Alexandra K
authors: AK
authors: Klein
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Allen.Morey@utsouthwestern.edu.
authors: Allen F
authors: AF
authors: Morey
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D012611:Scrotum / Q000637:transplantation*; D013524:Surgical Flaps; D013521:Urologic Surgical Procedures, Male / Q000379:methods