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Abstract
External genitalia trauma including penis and scrotum often accompanies with genitourinary trauma or occurs independently, especially in male. External genitalia trauma is an emergent and serious condition like urinary system trauma but it has been unnoticed in urologic field. The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important because it impacts the method of treatment however there has been no universe description about the classification of external genitalia trauma. The aim of this article is to summarize the methods of repairing defect in the penis and scrotum and the clinical application to the reparative treatment according to classification by its nature of injury.
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Fig. 1.
Schematic representation of classification.3 Type I injury: the most proximal part of corpora are intact and urinary meatus is on surface of palpable corporal stump, Type II injury: signifies almost total loss of corpora except for crura, Type III injury: voiding through perineal urethrostomy, Type IV injury: no identifiable urethra in perineum and suprapubic catheter is in place.
Fig. 2.
Schematic drawing of the modified string method.9 (A) Ligature of silk string is passed proximally through bearing. (B) Dark blood exudes continuously through medicut needle during winding of silk string. Bearing is the pushed distally 3 to 4 mm down compressed area.
Fig. 3.
Reimplation using burrowing method.17 (A) make tunnel underneath skin of the scrotum, (B) denuded, anastomosed penis in the tunnel, (C) close window, remove the catheter, (D) after 6 to 8 weeks, make incisions over scrotal skin along penile shaft. Catheter is reinserted to facilitate manipulation of the penis, (E) raise penile shaft from scrotal sac along with skin covering it, (F) suture skin edge together to separate penis from scrotal sac.
Table 1.
Currently used, refined techniques, for sex reassignment surgery, longterm follow-ups, and limits19
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