Herein, polyorchidism possessing of more than the usual number of testicles, which was found in two patients, is reported. Both patients had three testes, and one presented with painful swelling of the right scrotum caused by torsion of the testis and the other revealed a non-palpable testis in the right hemiscrotum. Both patients were managed surgically with orchiopexy and an orchiectomy, respectively, followed by the insertion of an artificial testis.
Humans ; Orchiectomy ; Orchiopexy ; Scrotum ; Testis ; Urogenital Abnormalities

PURPOSE: Some patients still complain of a downward urine stream and a poor cosmetic result after the standard surgery, scrotoplasty because many patients with hypospadias basically have a low-set penis. We applied and evaluated a new concept for the surgery to improve the surgical results. MATERIALS AND METHODS: 22 patients underwent surgery for PST from January 1997 to June 2004. We performed transposition of penis in 7 patients, scrotoplasty in 13 and partial wedge resection of the scrotum in 2 who had the mild form of PST. Transposition of the penis is a surgical technique in which the skin of the penoscrotal junction is incised circumferentially and phallus is delivered into the buttonhole that is created in the normal anatomical position for the penis. We evaluated the cosmetic results using a satisfaction scoring system (1 to 5 scores) that was completed by the parents and the functional results by checking the angle of the urine stream in the standing position. RESULTS: There was no major complication for the 7 patients who underwent transposition of the penis. The mean satisfaction score was 4.6+/-0.8 and the angle of the urine stream was above 45 degrees in all patients. In the case of scrotoplasty, the mean satisfaction score was 3.6+/-0.9: half of them showed an angle of urine stream under 45 degrees and they complained of trouble when voiding. CONCLUSIONS: As the anatomical location of the penis, scrotoplasty is good for the normally positioned penis with PST, transposition of the penis for the low-set penis, and partial resection of the scrotal skin for the mild form. This individualized approach could improve the cosmetic and functional results for patients with PST.
Female ; Humans ; Hypospadias ; Male ; Parents ; Penis* ; Rivers ; Scrotum ; Skin ; Urogenital Abnormalities

Congenital anomalies of the scrotum are uncommon and among them the ectopic scrotum is extremely rare. Only one case of ectopic scrotum has been recorded in Korea. In 1993 we experienced a case of unilateral ectopic scrotum with no other congenital abnormalities in a 22-year-old man. His left scrotum was normal in position and size, and contained a normal palpable testis. There was definite median raphe but no scrotal development to the right of this line. The penis showed externally normal appearance. A large sac of skin, having the typical hyperpigmented wrinkled appearance of normal scrotum, was overlying right inguinal ring. The sac contained a normally developed testis.
Congenital Abnormalities ; Humans ; Inguinal Canal ; Korea ; Male ; Penis ; Scrotum* ; Skin ; Testis ; Young Adult

OBJECTIVETo search for a simple and effective surgical approach to the management of moderate to severe pediatric concealed penis in children.

METHODSWe used Devine's technique via incision between the penis and scrotum in the treatment of 68 cases of moderate to severe pediatric concealed penis. The patients were aged 3 -13 (mean 6.5) years, 30 with moderate and 38 with severe pediatric concealed penis.

RESULTSThis strategy achieved good near- and long-term effects and satisfactory appearance of the penis, which was similar to that of circumcision. At 3 months after surgery, the penile length was 3 - 5.2 cm, averaging (2.35 +/- 0.35) cm.

CONCLUSIONDevine's technique via incision between the penis and scrotum is a simple and effective surgical option for moderate to severe pediatric concealed penis in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; surgery ; Urologic Surgical Procedures, Male ; methods

OBJECTIVETo investigate the therapeutic effect of penoplasty with scrotal skin flap for the treatment of buried penis in children.

METHODSThe narrow ring was cut vertically at the ventral side of penis and the prepuce inner plate was circularly cut 0.5 cm from the coronary sulcus. The prepuce was degloved to the base of penis. The abnormal aponeurosis was removed completely. The prepuce was designed to cover the coronary sulcus. The scrotal flaps at both sides were formed and advanced to cover the penile base. Then the prepuce was sutured to reconstruct penile-scrotal angle and scrotum plasty was completed.

RESULTSFrom March 2009 to July 2011, 24 children with buried penis were treated with scrotal flaps. Adhesion at external orifice of urethra was happened in two cases which recovered after urethra expansion. There was one case of necrosis at the distal end of prepuce. All the cases were followed up for 6 months to 2 years with no penile shrinkage. The penile appearance was good without rotation or lateral curvature during erection.

CONCLUSIONSThe buried penis can be best corrected with scrotal flap. It is an ideal method with less complication.

Child ; Child, Preschool ; Humans ; Infant ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; surgery ; Surgical Flaps ; Treatment Outcome

Occasionally, in obese infants or boys, the penis appears extremely short or absent because of fat deposits in the prepubic area. However, further inspection shows the penis to be of adequate length. A concealed penis is a congenital abnormality wherein the skin is unattached to the penile shaft. The penis itself is normally formed. The testes and scrotum are normally developed also. Its treatment is effected by weight reduction and surgery. Surgery is directed to fix the skin in the pubic area to the base of the penis. herein we report twelve cases of concealed penis with the literature review.
Congenital Abnormalities ; Humans ; Infant ; Male ; Penis* ; Scrotum ; Skin ; Testis ; Weight Loss

"13q-"syndrome is known to have widely variable manifestations, including retinoblastoma, mental and growth retardation, malformation of brain and heart, anal atresia, and anomalies of the face and limbs. Here we report a case of del(13)(q22) with multiple major congenital anomalies for the first time in Korea. The patient was born at 36+4 weeks of pregnancy by caesarian section. Birth weight was 1490g. On examination the following features were noted: - imperforate anus, ambiguous genitalia (bifid scrotum, penoscrotal transposition, hypospadia), syndactyly of toes, absence of thumbs, abnormal facies (dolichocephaly, telecanthus, large low set ears, saddle nose, high arched palate, micrognathia). Neurocranial ultrasonography showed atrophy of the corpus callosum and multiple calcifications. He died at 14 days. Post-mortem autopsy findings showed cholestasis and fatty metamorphosis of liver, abnormal lobulation (Rt:2, Lt:1) and lymphangiectasis of the lung, VSD, ASD, PDA of heart, and acute tubular necrosis of kidney. Cytogenetic studies was confirmed to 46,XY,del(13) (q22) by Giemsa banded chromosomes from peripheral blood lymphocytes.
Abnormalities, Multiple/*genetics ; Anus, Imperforate/*complications ; Case Report ; Chromosomes, Human, Pair 13/*genetics ; Fatal Outcome ; *Gene Deletion ; Human ; Infant, Newborn ; Male ; Penis/*abnormalities ; Scrotum/*abnormalities

One of the challenges in andrology nowadays is the diagnosis and treatment of external genital abnormalities and defects along with the consequent voiding, sexual, and reproductive dysfunctions, for which no guidelines are yet available. Hitherto, surgical repair and reconstruction are efficient for these diseases. The key to these operations is to individualize surgical strategies according to the specific local lesion and dysfunction, usually involving flap and graft techniques. This article presents our experience in the surgical treatment of penile and scrotal abnormalities and defects with urological and andrological techniques and microsurgical strategies, focusing on the external repair and functional reconstruction. Satisfactory treatment outcomes pivot on a precise evaluation of the disease, a rational design of surgical procedures, and an earnest communication with the patient. Some cases are rather complicated and challenging, usually with complications, and therefore deserve further researches for more effective treatment strategies in clinical practice.
Andrology ; Genitalia, Male ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Scrotum ; abnormalities ; surgery ; Surgical Flaps ; Treatment Outcome

The authors had five cases of penoplasty from more than half of the scrotum to the suprapubic region using a fasciocutaneous radial forearm free flap (RFFF) after extensive excision of sclerosing lipogranuloma. Although the harvested RFFF was a rectangular shape, the authors made the shape of scrotum, penile shaft, and suprapubic region by using well designed geometry and several quilting sutures on junction of scrotum and penis. The contour of scrotum and penis was well maintained, and there were no complications, such as scrotal contracture, penile deformity, and erectile dysfunction during the one year follow up period in all five cases. There were no recurrent lesions and no need for further surgery.
Congenital Abnormalities ; Contracture ; Erectile Dysfunction ; Follow-Up Studies ; Forearm* ; Foreign-Body Reaction ; Free Tissue Flaps* ; Granuloma ; Male ; Penis ; Scrotum* ; Sutures

OBJECTIVETo provide ideal materials for repair of penile wounds in penis lengthening.

METHODSA skin incision was made between the penis and mons pubis. Penis lengthening was performed by complete releasing of the superficial suspensory ligament and partial releasing of the deep suspensory ligament of the penis. Resurfacing of the defects at the penile base was accomplished by transferring a scrotal dartos musculocutaneous flap pedicled on the anterior scrotal vessels.

RESULTS16 patients with short penis were treated with the method. All scrotal dartos musculocutaneous flaps survived and 4-4.5 cm extra length of the penile shaft was achieved. Appearance and function of the penis were improved.

CONCLUSIONSThe scrotal dartos musculocutaneous flap is one of the best materials to repair the penile skin defects in penile lengthening operation. The advantages of the flap are: 1. good blood supply; 2. thin and lacking of subcutaneous fat; 3. extensibility with the scrotal dartos muscle.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; Surgical Flaps ; Treatment Outcome ; Wounds and Injuries