Nonerectile penile reconstruction following total penectomy using scrotal myocutaneous flap in carcinoma penis

Background : Patients who undergo total penectomy for carcinoma of penis and accidental injury to penis and penile urethra require perineal urethrostomy. This forces these patients to micturate in sitting position. Perineal urethrostomy is also associated with ammoniacal smell and perineal excoriation, unless the total penectomy is associated with emasculation.
Objective: This study aims to form esthetically acceptable nonerectile phallus with voidable urethra without giving enough bulk to the phallus using a myocutaneous scrotal flap for good act of micturition like male phallus after total penectomy.
Materials and Methods : The procedure was carried out on three patients. Patients undergoing total penectomy counseled for the proposed modification of the standard surgical protocol were clinically Stage II (Jackson B). The procedure is single-stage following total penectomy, after an interval of six months. Patients were followed up once a fortnight and evaluated for quality of stream and patient′s acceptance.
Results : All patients had aesthetically acceptable phallus without bulk, were able to micturate in standing posture in an upright directable fashion. Conclusion : The procedure is technically easy, esthetically acceptable and provides voidable urethra facilitating the act of micturition in standing posture without bulk to the reconstructed phallus.

Keywords
Nonerectile penile reconstruction, upright directable stream, voidable urethra