PMC4268758_01
Clinical presentation. (a) ruptured RD over the perineum (white arrow) and ectopic right scrotum (black arrow) along with penoscrotal transposition. A normal anal opening (blue arrow) was present at the orthotopic site. (b) RD mucosa (white arrow) which was extending up to penoscrotal area with adjoining mucosa, penoscrotal hypospadiac meatus (black arrow) along with uroepithelial-lined (blue arrow) urethral plate. The black-dotted mark circumferentially is showing a line of incision
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F1
He also had penoscrotal hypospadias with penoscrotal transposition and ectopic right scrotum [Figure 1a and b].
Intraoperative image; RD excised completely and both scrotum mobilized for reconstruction
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F2
Subsequently excision of RD was performed by an anterior sagittal approach [Figure 2], the full thickness rectal patch was dissected free from perineal skin and mobilized from underlying rectum.
Postoperative outcome; final outcome after urethroplasty. The perineal wound (black arrow) can be seen, healed by secondary intention
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F3
Later, colostomy was closed and hypospadias was corrected by tubularized incised plate (TIP) urethroplasty repair [Figure 3].