Penile torsion repair using dorsal dartos flap rotation

Abstract

Purpose: Counterclockwise penile torsion is a frequently noted congenital deformity. Previously proposed techniques of torsion repair are ineffective or pose significant operative risks. We introduce a novel technique using dorsal dartos flap rotation. Materials and Methods: The penis is first degloved completely and a broad based dartos flap is mobilized from the dorsal penile skin. The flap is rotated around the right side of the penile shaft and attached to the ventral aspect, causing clockwise penile rotation. Final slight adjustments are made during skin closure. We applied this technique in 8 patients undergoing circumcision (2), chordee (4) or hypospadias (2) repair. Results: This technique was effective for correcting penile torsion in all patients. At a mean followup of 8.3 months the cosmetic outcome was satisfactory with the complete correction of penile torsion. Conclusions: Rotational repositioning of a dorsal dartos flap is an effective technique for correcting penile torsion and it is easily applicable with other penile reconstruction procedures.