Reconstruction after total penile amputation and emasculation.

Amputation of the penis and testes is a rare injury in the pediatric population. The authors describe a case of traumatic amputation of the penis and testes presenting late for surgical reconstruction. The surgical reconstruction of this phallus involved advancement of the residual erectile tissue by division of the suspensory ligaments of the penis to lengthen the phallus. A glans penis was fashioned using a full-thickness skin graft with shaft skin provided by a split-thickness skin graft. The use of a tissue expander allowed the creation of a scrotum that accepted two testicular prostheses. Reconstruction of the phallus using these techniques allowed the creation of an erectile, esthetically acceptable phallus. In the situation in which residual erectile tissue remains, this technique can be effectively used in place of musculocutaneous transfer flaps or gender reassignment.