BACKGROUND: The goal of total phallic construction is the creation of a sensate and cosmetically acceptable phallus. An incorporated neourethra allows the patient to void while standing, and the insertion of a penile implant allows the patient to resume sexual activities, thus improving quality of life. OBJECTIVE: To report our experience of total phallic construction with the use of the radial artery free flap in female-to-male transsexuals. DESIGN, SETTINGS, AND PARTICIPANTS: The notes of the 115 patients who underwent total phallic construction with the use of the radial artery-based forearm free flap between January 1998 and December 2008 were reviewed retrospectively. MEASUREMENTS: The surgical outcome, cosmesis of the phallus, complications, eventual need for revision surgery, and patient satisfaction were recorded during the follow-up. RESULTS AND LIMITATIONS: This technique allowed the reconstruction of a cosmetically acceptable phallus in 112 patients; 3 patients lost the phallus due to venous thrombosis in the immediate postoperative period. After a median follow-up of 26 mo (range: 1-270 mo), 97% of patients are fully satisfied with cosmesis and size of the phallus. Sensation of the phallus was reported by 86% of patients. Urethral strictures and fistulae in the phallus and join-up site were the most common complications, occurring respectively in 9 and 20 patients; however, after revision surgery, 99% of patients were able to void from the tip of the phallus while standing. CONCLUSIONS: The radial artery-based forearm free flap technique is excellent for total phallic construction, providing excellent cosmetic and functional results.
BACKGROUND: The goal of total phallic construction is the creation of a sensate and cosmetically acceptable phallus. An incorporated neourethra allows the patient to void while standing, and the insertion of a penile implant allows the patient to resume sexual activities, thus improving quality of life. OBJECTIVE: To report our experience of total phallic construction with the use of the radial artery free flap in female-to-male transsexuals. DESIGN, SETTINGS, AND PARTICIPANTS: The notes of the 115 patients who underwent total phallic construction with the use of the radial artery-based forearm free flap between January 1998 and December 2008 were reviewed retrospectively. MEASUREMENTS: The surgical outcome, cosmesis of the phallus, complications, eventual need for revision surgery, and patient satisfaction were recorded during the follow-up. RESULTS AND LIMITATIONS: This technique allowed the reconstruction of a cosmetically acceptable phallus in 112 patients; 3 patients lost the phallus due to venous thrombosis in the immediate postoperative period. After a median follow-up of 26 mo (range: 1-270 mo), 97% of patients are fully satisfied with cosmesis and size of the phallus. Sensation of the phallus was reported by 86% of patients. Urethral strictures and fistulae in the phallus and join-up site were the most common complications, occurring respectively in 9 and 20 patients; however, after revision surgery, 99% of patients were able to void from the tip of the phallus while standing. CONCLUSIONS: The radial artery-based forearm free flap technique is excellent for total phallic construction, providing excellent cosmetic and functional results.
Authors: Nina Callens; Griet De Cuypere; Guy T'Sjoen; Stan Monstrey; Nicolaas Lumen; Erik Van Laecke; Piet Hoebeke; Martine Cools Journal: World J Urol Date: 2014-03-29 Impact factor: 4.226
Authors: Maria T Huayllani; Daniel Boczar; Humza Y Saleem; Gabriela Cinotto; Francisco R Avila; Oscar J Manrique; Pedro Ciudad; Brian D Rinker; Antonio J Forte Journal: Ann Transl Med Date: 2021-04
Authors: Miroslav L Djordjevic; Marko Bencic; Vladimir Kojovic; Borko Stojanovic; Marta Bizic; Sinisa Kojic; Zoran Krstic; Gradimir Korac Journal: World J Urol Date: 2019-01-23 Impact factor: 4.226