Scrotoplasty

What is scrotoplasty?

Scrotoplasty is surgery to treat conditions that affect your scrotum or create a new scrotum. Your scrotum is a layered pouch beneath your penis that holds and protects your testicles.

Why would someone need a scrotoplasty?

There can be many reasons children and adults have a scrotoplasty. Some people are born with medical conditions that affect their scrotums, and others develop conditions in adulthood. Others may choose to alter or create a scrotum for other reasons.

Buried penis

Children and adults can have buried penis. In children, it’s a congenital condition (something you’re born with) where the penis may appear hidden under the skin of the scrotum, thigh or abdomen, either from birth or as a result of previous procedures such as circumcision that removes too much (or not enough) foreskin.

Buried penis in adults is commonly a result of obesity with overhanging fat from the lower abdomen or from conditions such as lymphedema (fluid buildup around your scrotum). Previous surgeries or complications from surgeries can also lead to buried penis.

Sagging or enlarged scrotum

Some people want a scrotal procedure for cosmetic reasons. Cosmetic scrotoplasty can lift a sagging or loose scrotum (scrotal lift). This type of scrotoplasty is more common in older adults when their scrotums naturally begins to sag as they lose muscle tone.

Scrotoplasty can also help people with large scrotums by making them smaller. People with enlarged scrotums may find sexual activity, exercise or other physical activities uncomfortable due to their scrotums getting in the way.

Webbed penis

Some people have a sail of skin connecting their scrotums to the shafts of their penises. It creates a weblike appearance (penoscrotal webbing). The webbing can sometimes impact sexual function and penetrative intercourse. This can lead people to choose scrotoplasty for cosmetic reasons.

Trauma or injury

Scrotoplasty can help repair a scrotum that’s damaged by trauma or injury.

Skin infection

A sometimes life-threatening bacterial infection called Fournier’s gangrene can cause the skin around your penis and scrotum to die. Typically, you’ll need multiple surgeries and a scrotoplasty can help repair your scrotum.

How should I prepare for a scrotoplasty?

Your healthcare provider will tell you what you should and shouldn’t do before surgery. Adults having scrotoplasty should:

• Avoid certain medications. You should stop taking medicine that can increase your bleeding risk a few days to a week before surgery. These medicines include blood thinners (aspirin or other medicines that prevent blood clots and strokes) and nonsteroidal anti-inflammatory drugs (NSAIDs). Be sure your provider knows about any medications or supplements you take.
• Avoid food and drink. Your surgeon may ask you to restrict food and beverages eight to twelve hours before surgery to avoid issues with anesthesia.

Since you’ll be taking pain medicine and feeling the effects of anesthesia, you should arrange to have someone drive you home after a scrotoplasty.

What happens during scrotoplasty to treat medical conditions?

The steps of your surgery will vary depending on your situation and anatomy, but a scrotoplasty for a buried penis or sagging scrotum may go as follows:

• You’ll get anesthesia either in the form of general anesthesia (unconscious for the surgery) or local anesthesia (numbing of the scrotum, but awake).
• Your surgeon will make an incision (cut) near the area where your penis and scrotum meet.
• Your surgeon will remove excess skin and tissue connecting your skin and penis.
• They may tighten the skin that connects your scrotum to the base of your penis.
• Your surgeon will close the incision using dissolvable stitches.
• A drain may be left in your scrotum to minimize swelling.

How long does a scrotoplasty take?

You can expect at least one hour for a scrotoplasty.

Is scrotoplasty painful?

Your healthcare team will make sure you’re comfortable and don’t feel pain during the procedure. But you can expect some soreness and discomfort during your recovery.

What happens after a scrotoplasty?

Typically, scrotoplasty is an outpatient surgery. This means you can go home the same day. Surgery for buried penis may require a hospital stay if you need a longer surgery. Your surgeon will schedule a follow-up appointment within a few weeks to check on how your recovery is going.

You can expect to have some pain for a few days after surgery, and swelling may last for weeks. Cold compresses and over-the-counter (OTC) pain relievers can usually help with this. Ask your provider which medications they recommend. Your provider may prescribe pain relievers to help manage pain.

Your healthcare provider will ask you to avoid sexual activity for at least two to three weeks. They’ll also let you know of any aftercare instructions you should follow during your recovery.

What are the risks or complications of scrotoplasty?

A scrotoplasty has some degree of risk, including:

• Allergic reaction to anesthesia.
• Bleeding, bruising and swelling.
• Damage to your urinary tract.
• Infections.
• Nerve injuries.
• Painful intercourse.
• Scarring or cosmetic issues.

Be sure you discuss the risks and all your options with your healthcare provider before surgery.

What are the benefits of scrotoplasty?

The benefits of a scrotoplasty mainly affect people’s quality of life and emotional well-being. The benefits include:

• Increased self-esteem: People feel more comfortable and desirable when they’re happy with the look of their scrotum. It can lead to more satisfaction and happiness in your sexual relationships.
• Urinary function: Buried penis can lead to difficulty urinating and leaking urine. Scrotoplasty may significantly improve your quality of life with urinating.

What is recovery like after scrotoplasty?

Depending on the extent of the procedure, you may need to stay in the hospital for a few days. In other cases, you can go home within a few hours of surgery. Your healthcare team will make sure your recovery is going well before they send you home.

You may have:

• A support garment like a jockstrap to stop your scrotum from shifting.
• A catheter (thin tube) to drain pee from your bladder and out of your body. You may need to use a catheter for several weeks while your genitals heal.
• Scrotal swelling for several months, with mild testicular pain.

When should I call my healthcare provider?

You should call your healthcare provider if you experience:

• Chest pain or arrhythmias (heart rhythm changes).
• Difficulty peeing, painful urination or blood in your pee.
• Fever.
• Nausea and vomiting.
• Shortness of breath.
• Signs of infection (oozing and discoloration) at the surgical site or catheter.

Does insurance cover scrotoplasty?

Most insurance providers, Medicare and Medicaid cover the cost of scrotoplasty to treat medical conditions like buried penis. They usually won’t cover cosmetic surgeries like a scrotal lift.