Autotransplantation of a Sacral Ectopic Phallus: A Case Report
Joseph M. Firriolo, MD1, Laura C. Nuzzi, BA2, Amir H. Taghinia, MD, MPH, MBA2, Brian I. Labow, MD2.
1University of California Davis Medical Center, Sacramento, CA, USA, 2Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Purpose: Penoscrotal transposition is a rare anomaly characterized by cephalad positioning of the scrotum relative to the penis. Extreme cases present a significant reconstructive challenge. We present our group's experience managing a patient with caudal regression syndrome and a sacral ectopic phallus. To our knowledge, this is the only report of a pediatric patient who has undergone autotransplantation of an ectopic phallus.
Methods: The patient is a 46XY male born with caudal regression syndrome and extreme penoscrotal transposition with sacral ectopic phallus. At 4 years-old he underwent autotransplantation of his phallus to an anatomic position in the groin. In the same operation he underwent surgical correction of lower extremity pterygium.
Results: Now 14 years-old, the patient has done well postoperatively. His phallus remains appropriately positioned and has continued to grow proportionately. He has undergone two revisions to improve the positioning of the scrotum and testes. His self-esteem, quality of life, and ability to walk have greatly improved.
Conclusions: With meticulous planning and a multidisciplinary approach, plastic surgeons may consider ectopic phallus autotransplantation for the profound functional and psychosocial benefits that may be achieved.
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