Abstract
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 fasciocutaneuos 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, followed-up of patients with pudendal thigh flap
was done regarding aesthetic, 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.
Patient and Methods: nineteen 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. Sex patients underwent bilateral and 7 patient 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 non-significant
changes 6months and one 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 aesthetic appearance
of the scrotum, without any significant effect on testicular function. |
