New reconstructive surgery for penile paraffinoma to prevent necrosis of ventral penile skin.

To introduce a new repair technique, inverted V-shape, for penile paraffinoma without necrosis of the ventral skin anastomosed. From March 2006 to July 2012, 34 patients underwent penile paraffinoma repair using the T-style or a new operation procedure, the inverted V-shape anastomosis with a bilateral scrotal flap. The patients were subdivided into 2 groups. In group 1, each patient underwent the T-style anastomosis. In group 2, each patient underwent the inverted V-shape anastomosis. Two circumferential incisions were made, one at the skin just proximal to the corona of the penis and one at the penoscrotal junction. Complete removal of the involved skin and subcutaneous tissue, including paraffinoma, was performed. Both scrotal flaps were drawn to the mid-dorsal portion of the corona after scrotal flaps were incised appropriately and sutured with a T-style anastomosis between the coronal and scrotal flaps. The ventral skin was anastomosed end to end to avoid the T-style anastomosis, similar to a dorsal anastomosis. We created an inverted V incision 1 cm below from the anastomosis site. The scrotal flaps were sutured layer by layer. All 14 flaps survived completely without the necrosis of the ventral skin. The results were successful and without any major complications. Penile resurfacing without the T-style anastomosis at the ventral corona with bilateral scrotal flaps is a new technique for repair of penile paraffinoma. It is an effective and reliable method, especially for the saving corona and scrotal flap anastomosed to the ventral penile body.