Summary
Introduction
Phalloplasty for penile insufficiency in biological men differs from trans-men by
incorporating native tissue. The study objective was to report surgical and functional
outcomes of phalloplasty in biological men.
Patients & methods
Phalloplasty was performed with a radial free forearm (RFFA) or pedicled anterolateral
thigh (ALT) flap. The tube-within-tube technique was used for urethroplasty. Complications
<30 d postoperative were categorized according to Clavien-Dindo.
Results
30 patients, median (IQR) age of 21 (18–30)y, were included. 17 patients (57%) had
penile insufficiency due to exstrophy or hypospadias surgeries, 7 patients (23%) due
to sexual development disorders. In 16 patients RFFA was used. 19 patients needed
urethroplasty, the rest catheterized through stoma. Median follow-up was 33 (14–80)mo.
Within 30 d postoperative, 1 patients (3.3%) had Clavien-Dindo II and 6 patients (20%)
Clavien-Dindo III complications. On long-term, 10 patients (33%) developed fistula,
6 needing urethroplasty. 7 patients (23%) had urethral strictures, all needing surgical
intervention. All patients but one (98%) had erogenous sensitivity in the neo-phallus.
All urethroplasty patients reported antegrade ejaculation. 16 patients (84%) voided
through the urethra. 21 patients (70%) had an erectile device implanted.
Conclusion
RFFA and ALT result in good erogenous sensitivity but fistulas and strictures are
frequent.
Keywords
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References
- Radial forearm phalloplasty: a review of 81 cases.Eur J Plast Surg. 2005; https://doi.org/10.1007/s00238-005-0743-1
- Total phallic reconstruction in female-to-male transsexuals.Eur Urol. 2010; https://doi.org/10.1016/j.eururo.2009.05.018
Article info
Publication history
Published online: April 24, 2020
Accepted:
April 8,
2020
Received in revised form:
April 3,
2020
Received:
January 30,
2020
Identification
Copyright
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
