Dr. Harold Reed Blog

Penile scrotal web redux | Dr. Harold Reed |Miami

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?

Bert

Dear Bert,

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.

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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

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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.

2/11

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

2/9 .

Hoping this is of help,

Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urolgical Surgery
305-865-2000

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