Reconstruction of high-grade post-circumcision penile injuries using fenestrated skin and oral mucosa grafts for glans resurfacing: a single-center experience.

PURPOSE: We aim to present a single-center experience using this combined technique for phallic reconstruction.

METHODS

Complicated circumcision cases referred to our department from June 2015 to May 2024 were reviewed. We identified consecutive cases who had been presented with grade III to V penile injury and subjected to phallic reconstruction by release of the subcutaneous corporal remnant and covering the exteriorized corporal remnant with a full-thickness skin graft and resurfacing of the glans penis by oral mucosa graft.

RESULTS

37 male children were identified. Age at surgery ranged from 9 months to 7 years, with a mean operative time of 150 min and follow-up of 3 months-5.5 years. Uneventful graft incorporation occurred in 29 patients, with all donor sites healing without morbidity. At 6 months, urethral patency and satisfactory cosmetic outcomes were achieved in all patients. Complications included total skin graft loss in 4 patients, partial skin graft loss in 3, and buccal mucosa graft eschar in 2.

CONCLUSION

Fenestrated full-thickness skin grafts for the shaft combined with fenestrated oral mucosa grafts for the glans provide a reliable approach to reconstructing severe post-circumcision penile injuries. This technique provides an encouraging aesthetic and functional result.