An innovative method of reconstructed penis reduction: a case report

BACKGROUND: Surgery to reduce the size of the reconstructed penis is uncommon. Patients who have undergone total penis reconstruction may want to reduce the size of their reconstructed penis due to convenience issues. To reduce reconstructed penis size, surgical treatment is essential. However, no research has thus far reported on this methodology. CASE DESCRIPTION: A 50-year-old Asian man experienced a nearly total loss of his penis due to trauma 30 years ago. He underwent nearly total penis reconstruction using a tubed abdominal flap. The patient’s reconstructed penis showed hypospadias, which caused discomfort during urination. The length of the penis was 17 cm. The patient felt that the reconstructed penis was too large, and a reduction surgery was planned for corrective action. Y-shape incision lines were applied on both lateral sides of the reconstructed penis to reduce the circumference, and curved incision lines were applied on the front and back of the penis to construct the neomeatus and glans of the penis. The incision was made, and the remnant tissue was dissected, with attention paid to avoid damage to the neourethra. After the tissue resection, the neourethra was isolated and resected to fit the height of the penis to construct the neomeatus and correct the hypospadias. An approximation was performed after the reconstructed penis reduction. CONCLUSIONS: Two years after the surgery, there were no complications, such as urethral stricture or fistula, and the patient was satisfied with the shape and size of the reduced penis (9 cm). The surgical reconstructed penis reduction procedure introduced in this case report achieved satisfactory aesthetic and functional results.