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KMID : 0358320060470030287
Korean Journal of Urology
2006 Volume.47 No. 3 p.287 ~ p.292
The Individualized Surgical Approach of Penoscrotal Transposition according to the Anatomical Position of the Penis
Yoo Chang-Hee

Moon Kyung-Hyun
Kim Kun-Suk
Abstract
Purpose: Some patients still complain of a downward urine stream and a poor cosmetic result after the standard surgery, scrotoplasty because many patients with hypospadias basically have a low-set penis. We applied and evaluated a new concept for the surgery to improve the surgical results.

Materials and Methods: 22 patients underwent surgery for PST from January 1997 to June 2004. We performed transposition of penis in 7 patients, scrotoplasty in 13 and partial wedge resection of the scrotum in 2 who had the mild form of PST. Transposition of the penis is a surgical technique in which the skin of the penoscrotal junction is incised circumferentially and phallus is delivered into the buttonhole that is created in the normal anatomical position for the penis. We evaluated the cosmetic
results using a satisfaction scoring system (1 to 5 scores) that was completed by the parents and the functional results by checking the angle of the urine stream in the standing position.

Results: There was no major complication for the 7 patients who underwent
transposition of the penis. The mean satisfaction score was 4.6¡¾0.8 and the angle of the urine stream was above 45o in all patients. In the case of scrotoplasty, the mean satisfaction score was 3.6¡¾0.9: half of them showed an angle of urine stream under 45o and they complained of trouble when voiding.

Conclusions: As the anatomical location of the penis, scrotoplasty is good
for the normally positioned penis with PST, transposition of the penis for the low-set penis, and partial resection of the scrotal skin for the mild form. This individualized approach could improve the cosmetic and functional results for patients with PST. (Korean J Urol 2006;47:287-292)
KEYWORD
Urogenital abnormalities, Scrotum
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