For some patients, surgery may be an option to correct problems that can lead to loss or disease of the genital skin or genitals. Our urological specialists are experts in treating and correcting these conditions.
Problems that can lead to genital reconstruction surgery may include:
- Fournier's gangrene,
- Excessive weight gain,
- Complications from penile enhancement surgery, and
- Buried or hidden penis.
Serious Infections of the Genitals (Fournier’s Gangrene)
Particularly in diabetic men, life-threatening infections can occur that affects the skin of the penis, scrotum, anus, and perineum (the area between the anus and the scrotum). Patients often become very ill with high fevers and emergency surgery is needed to remove the infected skin, in order to save the patient’s life.
After surgery there is a large defect in the area where the skin was removed. The underlying structures and tissue of the penis and testicles is exposed when the skin is removed and needs to be repaired. This problem is best repaired with skin flaps or grafts placed over the testicles and the penis.
Skin grafts are usually taken from the thigh or the abdomen. Sometimes the testicles are placed into pouches made in the thigh to protect them if a skin graft cannot be fashioned to cover them. The recuperation from this problem can take some time and patients are often best treated in a hospital with a burn intensive care unit since treatment of the skin problem is very similar to the treatment of a serious burn.
Lymphedema refers to swelling of the genital skin. This swelling is the result of damage to the lymph channels leading away from the genitals.
This damage to the lymph channels can be caused by:
- Chronic infection
- Radiation, or
- Previous surgeries.
The condition leads to painful swelling of the skin surrounding the genitals and may act to obstruct normal sexual and urinary function. The affected skin often has a doughy appearance from accumulation of excess fluid that is normally drained by the lymph channels.
The treatment for this condition, when it does not respond to simple medicines such as a pill to remove excess fluid, is surgical removal of the skin and skin grafting of the penis and scrotum.
Complications From Penile Enhancement Surgery
There are many patients that undergo ill-advised surgery to enhance the length or width of the penis. These surgeries are rarely successful and can lead to severe complications.
One of these common procedures is to inject material along the shaft of the penis to increase the girth or width of the penis. The types of material used to inject the penis range from fat cells to silicone material. This material can lead to chronic swelling and pain in the skin of the penis or to very hardened abnormal scarring surrounding the penis and scrotum. The result is debilitating and leads to chronic pain and sexual dysfunction.
Usually in order to reconstruct this problem the foreign material needs to be removed along with the skin that is involved in the scarring or inflammation. Sometimes skin grafts need to be performed when a large amount of the skin is involved with infection or scarring.
Buried or Hidden Penis
When they gain weight, many men feel that their penis shrinks. This is not what actually happens. The penis is anchored to the pubic bone and as men gain weight the fat pad above the pubic bone grows and surrounds the penis covering it up and making it appear to shrink.
If the situation is serious enough, it can lead to problems with urination and sexual function. The penis appears to be dramatically retracted and the head of the penis cannot be exposed to allow for urination. This leads to a lot of chronic irritation and discomfort from urinary spraying.
This is a difficult problem but can be treated by either one of the following:
- Weight loss
Surgery - Panniculectomy
Surgery involves removal of the fat pad overlying the penis. This is called a panniculectomy. The penile skin is often chronically infected and in some cases this needs to be removed, and patients needs a skin graft placed around the shaft of the penis. This surgery is not easy but can resolve this problem if weight loss is not feasible.
William O. Brant, MD FACS FECSM, is a board-certified urologist, specializing in sexual dyfunction, disorders of the penis, Men's health, Peyronies diesease, male urinary incontinence, scrotal and testicular problems, and prosthetic surgery. He attended Dartmouth College (undergraduate) and the University of Washington, Seattle (graduate) and then ... Read More
Dr. Hotaling has significant training in both the clinical aspects of male fertility and genetic epidemiology and he is currently the only fellowship trained male infertility/andrology expert in Utah. He completed a 6 year residency in urology at the University of Washington, elected to pursue a year of sub-specialty training in male infertility ... Read More
Richard is a board certified Physician Assistant. His clinical emphases include men’s health and general urology as well as clinic procedures for hypogonadism, erectile dysfunction, incontinence and Peyronie’s Disease. He works closely with the physicians of the Men’s Health Clinic, including pre-operative and postoperative care. He is a member of ... Read More
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Dr. Lenherr is a urologist who focuses on treatment of female incontinence and management of bladder dysfunction. She received her medical degree from the University of Chicago and completed a 6-year residency in urology at the Lahey Clinic outside of Boston. She then elected to pursue two years of sub-specialty clinical training in female pelvic m... Read More
Bladder Augmentation, Chronic Urinary Tract Infections, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Female Incontinence, Incontinence, Mesh Erosion, Neurogenic Bladder, Pelvic Dysfunction/Incontinence, Trauma and Reconstructive Urology, Urology, Vesicovaginal Fistula
Dr. Myers completed specialty training with Dr. Jack McAninch at University of California, San Fransisco. His fellowship was in trauma and urologic reconstructive surgery. In his practice, Dr. Myers treats a variety of conditions. These include conditions like urethral strictures, ureteral scarring from previous surgery or congenital development... Read More
Bladder Augmentation, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Female Incontinence, General Urology, Mesh Erosion, Neurogenic Bladder, Pelvic Fractures and Urethral Injury, Radiation Injuries, Trauma and Reconstructive Urology, Ureteral Stricture, Urethral Stricture, Urinary Diversion, Urinary Strictures and Fistula, Urology, Vesicovaginal Fistula
Kelley is a board-certified adult-gerontology acute care nurse practitioner (AG-ACNP). She has been with the University of Utah Department of Urology since 2014. Prior to this, her educational emphasis was adult urology. Clinical emphases include men’s health and male infertility as well as clinic procedures for hypogonadism, erectile dysfunction, ... Read More
Kathryn (Kate) Trueheart, PA-C, grew up in Rochester, New York and attended Boston University where she completed an undergraduate degree in East Asian studies. From there she went to Berkeley, California, where she attended Meiji College of Oriental Medicine, earned a master of science in Oriental medicine and became a licensed acupuncturist. Aft... Read More