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Scrotal Flaps for Penile Skin Reconstruction: A Systematic Review
Sorin V Parasca1,2, Andrei Dumitrescu1,2, Florin R Stanescu2
1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Medicina (Kaunas, Lithuania)
|June 27, 2025
Summary
Scrotal flaps offer high patient satisfaction for penile skin reconstruction, providing quality tissue similar to normal penile skin. Further research is needed to evaluate complications and erectile function for different flap types.
Area of Science:
- Urology
- Plastic Surgery
- Reconstructive Surgery
Background:
- Penile skin defects stem from infection, trauma, cancer, injections, and lymphedema.
- Scrotal flaps are a reconstructive option for penile resurfacing, but superiority is debated.
Purpose of the Study:
- To review and synthesize the literature on scrotal flap use for penile skin defects.
- To evaluate outcomes and patient satisfaction associated with various scrotal flap techniques.
Main Methods:
- A comprehensive literature review was conducted using PubMed Central and Scopus.
- 32 articles (13 case reports, 19 case series) involving 368 patients were selected.
Main Results:
- Sclerosing lipogranuloma was the most common indication (71%).
- Seven types of scrotal flaps were utilized, with bilateral anterior scrotal flaps and bipedicled bilateral anterior scrotal flaps being most frequent.
- High patient satisfaction was reported across studies, though outcome evaluation often relied on subjective measures.
Conclusions:
- Scrotal flaps provide excellent tissue for penile reconstruction, closely matching normal penile skin.
- Standardized evaluation of complications, length of stay (LOS), and revision rates is recommended.
- Comprehensive assessment of erectile function using validated tools like the International Index of Erectile Function (IIEF-5) is crucial.
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