Introduction
Reconstruction of major scrotal defects represent a great challenge for surgeons.
Although a lot of therapeutic methods have been established for the reconstruction
of these defects, each technique has its own advantages and disadvantages. The
pudendal thigh flap is an axial and sensate fasciocutaneous flap based on the
terminal branches of the superficial perineal artery, which is a continuation of the
internal pudendal artery (below the urogenital diaphragm). The data on the
testicular function after reconstruction of cover for the testes have been rarely
reported. In this study, follow-up of patients with pudendal thigh flap was done
regarding esthetic outcome, functional outcome, and testicular function.
Aim
The aim of this study was to show the versatility and usefulness of posteriorly based
pudendal thigh flap for scrotal reconstruction and to evaluate its effect on testicular
function.
Patients and methods
A total of 19 flaps in 13 patients with major scrotal defects were subjected to
reconstruction using posteriorly based pudendal thigh flap. The cause of scrotal
skin loss was Fournier gangrene in nine cases, trauma in three cases, and animal
bite in one case. Six patients underwent bilateral flap reconstructions, and seven
patients underwent unilateral flap reconstructions.
Results
All 19 flaps survived completely with good color matching. The donor site was
closed directly, and the scar was hidden in the inguinal crease. One patient had
wound dehiscence in the donor site and required a secondary procedure for
healing. Testicular function regarding spermatogenesis and hormonal functions
showed nonsignificant changes 6 months and 1 year after flap coverage.
Conclusion
Posteriorly based pudendal thigh flap is a good option for reconstruction of major
scrotal defects. This flap gives a wide coverage with excellent esthetic appearance
of the scrotum, without any significant effect on testicular function. |
