V8-08: Reduction scrotoplasty with simultaneous placement of inflatable penile prosthesis
VideoIntroductions and Objectives
Placement of inflatable penile prosthesis is a common urologic surgery that dramatically aids patients with erectile dysfunction. There are a proportion of patients that have a severely redundant scrotum that can cause functional discomfort or pain due to the large size. We present a novel technique for reduction scrotoplasty with simultaneous placement of inflatable penile prosthesis.
A penoscrotal approach is taken for placement of the inflatable penile prosthesis. A ventral phalloplasty is performed using our previously described approach to excise the redundant skin at the penoscrotal web. We then follow our standard protocol for insertion of the penile prosthesis. The prosthesis pump is positioned in the most inferior portion of the scrotum. An inverted-Y reapproximation of the dartos layer is performed, and the overlying skin closed in the same fashion. This results in cephalad retraction of the scrotum, thus providing an overall reduction of scrotal sac dimensions.
A total of seven patients have undergone reduction scrotoplasty with simultaneous placement of inflatable penile prosthesis at our institution. At last follow up, all patients have excellent cosmetic and functional outcomes. No known complications have occurred due to the reduction scrotoplasty.
Inverted-Y reduction scrotoplasty is a feasible technique during placement of inflatable penile prosthesis. The added time during surgery is minimal, and functional outcomes are excellent. This simultaneous procedure can lead to improved quality of life for patients with concurrent erectile dysfunction and redundant scrotum.