Inflatable penile prosthesis technique and outcomes after radial forearm free flap neophalloplasty

Segal, Robert; Massanyi, Eric Z.; Gupta, Ashish; Gearhart, John P.; Redett, Richard J.; Bivalacqua, Trinity J.; Burnett, Arthur L.

doi:10.1038/ijir.2014.30

Cited by 27 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Penile prosthesis implantation represents the only solution to achieve the rigidity necessary for penetrative sexual intercourse, although complication rates are significantly higher than for virgin penile prosthesis implantation. 24,25 However, the 50% revision rate in this study is in line with those of other recent larger series. 5,8,9 …”

Section: Discussionsupporting

confidence: 92%

Total Phallic Reconstruction Using the Radial Artery Based Forearm Free Flap After Traumatic Penile Amputation

Falcone

Garaffa

Raheem

et al. 2016

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Introduction Although genital injuries in civilian centers are rare, the scenario is completely different in the battlefield. If the penile distal stump is not adequate for primary reimplantation or it cannot be found, then delayed penile reconstruction needs to be considered. Aim To report a single-center experience with total phallic reconstruction using radial artery based forearm free flap (RAFFF) after penile traumatic loss. Methods We retrospectively reviewed the clinical records of 10 patients who underwent total phallic reconstruction with the use of the RAFFF from September 2001 through August 2015 after traumatic amputation of the penis. Main Outcome Measures Patients' baseline features, surgical outcomes, complications, and satisfaction are reported. Results The average age at the time of penile reconstruction was 36 years (range = 27–52 years). The causes of penile loss were self-amputation owing to an acute schizophrenic episode (n = 2), road traffic accident (n = 3), blast injury (n = 3), donkey bite (n = 1), and Fournier gangrene (n = 1). The average time from the trauma to reconstruction with the RAFFF was 7 years (range = 2–15 years). The urethral stump was adequate for primary anastomosis, with phallic neourethra construction in six patients. The remaining patients had complete avulsion of the penis and were voiding though a perineal urethrostomy. In consequence, they required a two-stage urethroplasty. An acute arterial thrombosis of the microsurgical anastomosis occurred in two patients and was managed successfully with immediate exploration. A neourethra stricture and fistula occurred in one patient, which needed revision. All patients who underwent complete urethral reconstruction could void and ejaculate from the tip of the phallus. After a median follow-up of 51 months (range = 1–114 months), all patients were satisfied with the size, cosmetic appearance, and sensation of the phallus. Six patients underwent inflatable penile prosthesis implantation and could engage in penetrative sex. However, revision surgery was needed in three patients (infection, n = 2; mechanical failure, n = 1). Conclusion Despite the high incidence of postoperative complications and the possible need for multiple operations, in expert hands and in large-volume centers, penile reconstruction with the RAFFF after traumatic loss of the penis yields excellent results and allows patients to regain sexual and urinary functions.

show abstract

Section: Discussionsupporting

confidence: 92%

Total Phallic Reconstruction Using the Radial Artery Based Forearm Free Flap After Traumatic Penile Amputation

Falcone

Garaffa

Raheem

et al. 2016

The Journal of Sexual Medicine

View full text Add to dashboard Cite

show abstract

“… noted a 44% prosthesis explantation rate due to malpositioning, technical failure, or infection. Other series have also noted similar rates of prosthesis‐associated complications , leading some to abandon use of prostheses altogether . In addition to implant‐associated complications, all of the described techniques for autogenous phalloplastic reconstruction suffer from unacceptably high rates of urethral complication.…”

Section: Limitations Of Traditional Reconstructive Optionsmentioning

confidence: 96%

Penile transplantation: an emerging option for genitourinary reconstruction

Tuffaha¹,

Cooney²,

Sopko³

et al. 2017

Transpl Int

View full text Add to dashboard Cite

Penile transplantation is an emerging option for patients with severe genital defects not amenable to traditional reconstructive options. In this article, we discuss the burgeoning problem of severe male genitourinary trauma in the military, the limitations of traditional reconstructive options in addressing these problems, and the potential for penile transplantation to provide improved outcomes. We also review the preclinical research and limited worldwide experience with penile transplantation to date, including lessons learned, and discuss the many important technical, logistical, and ethical considerations pertaining to penile transplantation that must be addressed to maximize the likelihood of successful implementation.

show abstract

“…To achieve a functional penis, patients with a neophallus need to undergo additional complex reconstruction for placement of an inflatable penile prosthesis. Although this technique has been well established, it still carries significant potential for catastrophic complications, such as infection, erosion, and even complete loss of the neophallus [1]. Neophallus techniques often do not represent an ideal option for individuals with extensive tissue loss secondary to combat-related trauma, as the extensive injuries and amputations to their limbs limit donor site availability.…”

Section: Introductionmentioning

confidence: 99%