Modified pudendal-thigh flap for correction of penoscrotal transposition

In patients with penoscrotal transposition, an occasional postoperative problem has been a deficiency of skin on the proximal penile shaft that results in penoscrotal fusion and tethering. We describe a new operation using a modified neurovascular pudendal-thigh flap for correction of incomplete penoscrotal transposition. This procedure has been used in 6 children, and an excellent cosmetic and functional result has been achieved in each patient. The flaps provide a reliable blood supply, maintain normal innervation and correct the problem of postoperative penoscrotal fusion and tethering. This technique preserves sufficient penile skin for a tension-free second-stage urethroplasty.