Updates in the management of benign and malignant scrotal conditions: issues on surgical ablation and reconstruction

Scrotal reconstruction is necessary after surgical excision of both malignant and benign lesions. Given the unique anatomy of the scrotum some of the usual reconstructive techniques do not apply or at least not in general. The rugated and elastic skin of the scrotum make it easier to compensate for tissue loss allowing reconstruction even if 60% of the skin has been lost. On the downside, the exposed position of the scrotum and its mobility as well as the need to cover the testes pose a certain barrier to using skin grafts limiting the choices of tissues that can be used for reconstruction. In the current article we will review the most common malignant and benign diseases that surgeons will encounter and describe a variety of reconstructive techniques that will cover the majority of scenarios that are encountered clinically.