Dr. Reed, am reviewing an article on penile-scrotal web (turkey neck) repair discussing the 2 approaches, Z-plasty vs. V-Y plasty. Any additional thoughts. How do you feel about electrolysis to remove hair on the penile shaft?
Regarding the 2 approaches, there’s a saying “if you ask 5 different urologists, you’ll get 7 different opinions.”
I have seen Z-plasty results (not so pretty) right here in my office
which were successfully revised.
A Z-plasty is a well recognized plastic surgical technique to provide
added length in one direction at the price of reducing length in another axis.
It is sometimes used to shift the axis of a scar into a more concealed area.
When it comes to penile scrotal webbing, the surgeon who does the Z-plasty believes he/she will provide added longitudinal length and thus relax the tension which has produced a penile-scrotal web
The purpose of the photo below, taken from my site on a patient who had simultaneous
circumcision and release of a congenital web, is to show that rugae or folds of the scrotum occur in a chevron like pattern. So the scrotal incision heals more imperceptibly. (Parallel to the rugae)
A vertical incision on the underside of the penis heals in the pigmented raphe area, and certainly when flaccid is not an attention getter.
As you can appreciate in the photo below, there is no insufficiency of penile skin, but the scrotum lacks dependency. Release of the web with a Y-V
plasty gives more (IMHO) of what belongs to Caesar (the scrotum) back to Caesar
Hoping this is of help,
Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urolgical Surgery