Correction of penoscrotal transposition: A novel approach

Purpose: Penoscrotal transposition is a rare anomaly resulting in a partial or complete positional exchange between the penis and the scrotum. Time-honored repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilize the scrotum. We offer a radically different approach to this anomaly by transposing the penis and not the scrotum to its normal anatomical location. Materials and Methods: Transposition of the penis was performed in 15 patients. The penis is degloved followed by correction of the chordee. A suprapubic buttonhole is created in an anatomically correct location for the penis. The degloved phallus is then delivered into this buttonhole. The shaft skin is mobilized and transposed to resurface the penile shaft. A midline scrotoplasty completes the first stage. The scrotum is never transposed and scrotal rotational flaps are unnecessary. Results: All 15 patients have had an excellent cosmetic outcome. There have been no cases of vascular compromise to the shaft or scrotal skin. Conclusions: This novel approach produces superior cosmetic results and should be used in all cases of penoscrotal transposition.