Lucas Jacob W, Lester Kyle M, Chen Andrew, Simhan Jay
Department of Urology, Einstein Healthcare Network/Fox Chase Cancer Center, Philadelphia, PA, USA.
Transl Androl Urol. 2017 Aug;6(4):710-721. doi: 10.21037/tau.2017.07.06.
Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty. Reconstruction is also commonly indicated following scrotal skin loss caused by infection, trauma, lymphedema, hidradenitis, and cancer. Although initial management of these conditions often involves scrotal skin removal, repair of expansive scrotal skin loss can be technically difficult and can be accomplished by using one of several skin flaps or skin grafting. Split-thickness skin grafting of scrotal defects can be accomplished easily, and provides durable results.
阴囊手术涵盖了各种各样的手术技术，适用于更为广泛的适应证。在本手稿中，我们回顾了各种阴囊重建手术的适应证、技术和陷阱，以及睾丸假体植入的手术技巧。阴茎阴囊蹼（PSW）是阴囊皮肤在阴茎腹侧远端的异常且常引发问题的附着。有几种有效且直接的技术可用于矫正这种情况，包括单纯阴囊成形术、单Z成形术或双Z成形术，或VY皮瓣阴囊成形术。在因感染、创伤、淋巴水肿、汗腺炎和癌症导致阴囊皮肤缺失后，重建手术也很常见。尽管这些情况的初始处理通常涉及阴囊皮肤切除，但修复大面积阴囊皮肤缺失在技术上可能具有挑战性，可通过使用多种皮瓣或皮肤移植之一来完成。阴囊缺损的中厚皮片移植操作简便，效果持久。
