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Phalloplasty in biological men with penile insufficiency

      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

        • Monstrey S.
        • Hoebeke P.
        • Dhont M.
        • Selvaggi G.
        • Hamdi M.
        • Van Landuyt K.
        • et al.
        Radial forearm phalloplasty: a review of 81 cases.
        Eur J Plast Surg. 2005; https://doi.org/10.1007/s00238-005-0743-1
        • Garaffa G.
        • Christopher N.A.
        • Ralph D.J.
        Total phallic reconstruction in female-to-male transsexuals.
        Eur Urol. 2010; https://doi.org/10.1016/j.eururo.2009.05.018