Glans penis coronaplasty with palmaris longus tendon following total penile reconstruction

Total penile reconstruction has been performed successfully with the use of vascularized flaps, to the point of obtaining a functioning penis where the patient can urinate voluntarily, have sexual relations, and obtain an acceptable reconstruction. Less attention has been paid to the cosmetic appearance, however, perhaps due to an already complex reconstructive effort. In particular, the anatomic distinction between the penile shaft and the glans penis in the reconstruction is commonly flat with absence of the corona. We present a 39-year-old male who underwent complete penile reconstruction following total penectomy for malignancy with a radial forearm osteocutaneous flap and had loss of the corona postoperatively. A palmaris longus graft was used for glans penis coronaplasty. The tendon graft provides autologous tissue, which is easy to harvest, has minimal donor morbidity, and structurally can be manipulated to provide tissue bulk for the reconstruction.