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

Purpose: We describe a method for avoiding perineal urethrostomy, and maint aining penile cosmesis and function after penile amputation. Materials and Methods: Penile reconstruction was performed in 1 patient wit h traumatic total amputation of the penis and 1 undergoing near total penec tomy 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 se nsation 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 wit h scrotal flaps minimize altered body image, and maintain sensation and nor mal voiding position.