Outcome of Ateya's technique (combined V-Y plasty scrotal and infrapubic skin flaps) as an innovative approach for challenging cases with severely denuded penises: A longitudinal cohort study.

PURPOSE: Severely denuded penises, though rare, can result in significant psychological distress, voiding difficulties, hygiene problems, and sexual dysfunction, as well as psychological distress for both patients and their parents. We evaluated the outcome of V-Y scrotal and infrapubic skin flaps to serve completely denuded penises in pediatric patients and adolescents following excess skin removal during circumcision and trauma.

METHODS

A retrospective review was conducted from April 2017 to April 2022 at a single center. A total of 49 patients with complete penile skin denudation who underwent flap reconstruction were enrolled. V-Y plasty flaps from scrotal and infrapubic skin were utilized to treat severely denuded penises. Eventually, patients' satisfaction was assessed using penile perception and Likert scales.

RESULTS

The mean overall penile perception score was 8.76 ± 2.09. The mean scores for shaft skin, penile axis, hair growth, and general cosmetic satisfaction were 2.27 ± 0.53, 2.35 ± 0.86, 1.69 ± 0.58, and 2.45 ± 0.61, respectively. Compared to the baseline measurements, there were significant differences in the visible postoperative penile length at 1 month and at the conclusion of the follow-up period (p < 0.001). Furthermore, there were substantial positive correlations between the scores for shaft skin, less hair growth, and less penile contracture and the overall cosmetic appearance (r = 0.24, p = 0.01; r = 0.74, p=<0.001; r = 0.67, p<0.001, respectively).

CONCLUSIONS

This study demonstrates that the use of V-Y scrotal and infrapubic skin flaps in the reconstruction of severely denuded penises offers a promising approach to reconstructive penile surgery. However, the increased likelihood of hair growth on the penile shaft continues to be a significant drawback.