Penoscrotal Webbing 

Overview

The scrotum in some men extends up the underside of the penis, creating an indistinct junction between the penis and scrotum. This penoscrotal webbing or “turkey neck” makes the penis appear short on its undersurface, and may restrict penetration during sexual intercourse.  It can cause discomfort during intercourse and/or difficulty using a condom. The web is commonly caused by removal of too much skin on the underside during a circumcision. But it may be congenital as well.

Procedure

A very mild web is eliminated by rearranging the tissues at the penoscrotal junction, leaving a zigzag incision (Z-plasty). The patient is given an erection during surgery with an injection of medication, so Dr. Alter can tailor the excision around an erect penis. A more severe web is eliminated by excision of the web and closure with a linear scar and Z-plasty. The incision is placed along the median raphe or natural fusion line mark of the body, so it is eventually difficult to see. Since scars have a tendency to shrink, a z-plasty is made at the junction of the penis and scrotum to prevent shortening with a recurrent web.  Some surgeons may remove the web by doing a VY incision, but this leaves a larger scar, doesn’t always correct the web, and commonly leaves “dog-ears” on the sides.

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