Scrotal reconstruction by testicular transposition after Fournier gangrene

Abstract

Context and objective. Perineo-scrotal gangrene (PSG) is a necrotizing fasciitis of the scrotum, which may extend to the perineum or beyond. Its surgical management leaves a loss of perineo-scrotal substance, which sometimes needs to be reconstructed. The aim of this study was to evaluate scrotal reconstruction by testicular transposition in our practice. Methods. Retrospective study of patients who underwent scrotal reconstruction by testicular transposition for a PSG in the Urology Department of the CHRASM in Louga (Senegal). The surgical techniques used were as follows: Step 1: Testicular burial on the anteromedial aspect of the thigh, under the skin; Step 2: Transposition of the skin-covered testicles to their anatomical position. Results. Ten patients were operated on using this technique. The PSG were of urogenital origin (4 cases), anal origin (2 cases) and of an unidentified origin (4 cases). Post-operative care was straightforward. Two patients did not present for the second operation. The cosmetic and anatomical result was considered good in terms of body image restoration in 8 patients. Conclusion. Scrotal reconstruction after PSG is challenging. Testicular transposition, performed in 2 stages, is a simple technique with good results.

Received: December 17^th, 2023

Accepted: August 4^th, 2024

https://dx.doi.org/10.4314/aamed.v17i4.12