Penile stump advancement as an alternative to perineal urethrostomy after penile amputation

Purpose: We describe a method for avoiding perineal urethrostomy, and maintaining penile cosmesis and function after penile amputation. Materials and Methods: Penile reconstruction was performed in 1 patient with traumatic total amputation of the penis and 1 undergoing near total penectomy for carcinoma by advancing the penile stump and covering the resultant phallus with rotational full thickness scrotal flaps. Results: Both patients were able to void while standing, and have intact sensation and erectile capability in the residual neophallus. Conclusions: Perineal urethrostomy is not necessary after penopubic penile amputation. Advancement of residual cavernosal tissue and skin coverage with scrotal flaps minimize altered body image, and maintain sensation and normal voiding position.