GLANS RESURFACING AND RECONSTRUCTION AFTER RESECTION OF BENIGNANT OR MALIGNANT LESIONS OF THE PENIS

Introduction
The video shows the resurfacing and reconstructing technique of the glans in the case of a severe Zoon's balanitis.

Materials and Methods

Patient 59 years old affected by severe Zoon's balanitis that caused costantly sore and painful glans, and subsequently prevented the sexual activity. The topic dermatological treatments had not solved the problem.
Surgical technique: by means of a demarcation pen the glans is divided into two emispherical areas. A circular incision is made under the corona degloving the penile skin. Glans-skinning: around the meatus we find the dissection plane between glans spongiosum and epithelium. The glans epithelium is fully removed up to the coronal sulcus.
Resurfacing: is a thin rectangular skin graft is harvested from the thigh using a manual dermatome. It is then adequately tailored and transplanted like an umbrella over the surface of the stripped glans. The graft is fully quilted over the glans with multiple 6/0 polyglactin interrupted stitches. The penile skin is sutured to the graft at the coronal sulcus.

Results
Four days after surgery, the patient is mobilised and discharged from the hospital if the graft is considered to be in good conditions and no penile hematoma, seroma or infection are present. Six months after surgery the glans has a satisfying aesthetical appearance and the symptomatology with rash and burning pain has disappeared. The patient was satisfied with his neophallic appearance and could resume the sexual activity.

Conclusions
In selected cases of benign, premalignant or malignant penile lesions, the glans resurfacing or reconstruction may guarantee a normal and functional appearing penis, without jeopardizing cancer control.
Disclamer
Caution! Surgical images