Penile reconstruction/formation

Abstract

Technical advances in penile reconstruction have been highlighted. The few long-term follow-up studies available confirm the difficulty of such surgery, in terms of complications and the limits of the final achievable outcomes. The surgery necessitates several steps and a high number of revisions. Scientific progress in penile reconstruction seems slow, with a lack of controlled studies, high rate of loss to follow-up (especially in sex reassignment surgery) and a lack of validated assessment measures. However, a few recent studies are making the problems clearer, especially in patient selection and the avoidance of raising false expectations in patients.

Aphallia: experience with 3 cases

“…These patients should also be kept under close follow-up so as to detect any deterioration in renal function early. Henceforth, the present consensus is male sex assignment, but it should be recognized that penile reconstructive surgery is demanding and often requires a number of revisions and one should be realistic when discussing the final achievable outcome with the parents [23,24].…”

“…They proposed early palliative phalloplasty using an abdominal wall skin flap in childhood until the patient can undergo definitive phalloplasty using a forearm free flap after puberty. Many other techniques such as anterolateral thigh flap and musculocutaneous latissimus dorsi flap [22][23][24] have also been described for phallic reconstruction. Musculocutaneous latissimus dorsi flap is mobilized on the subscapular artery and vein and the thoracodorsal nerve.…”

Preconstruction of the Pars Pendulans Urethrae for Phalloplasty with Digestive Mucosa Using a Prefabricated Anterolateral Thigh Flap in a One-arm Patient

“…2 However, it is obviously not suitable for this patient. Moreover, the extensive scarring of both abdomen and scrotum limits the use of local tissue for urethroplasty and his anterolateral thigh with a pinch thickness of 3.5 cm is too thick and bulky to use the tube-within-a-tube design.…”

“…Construction of a neourethra is always considered to be a difficult part of phalloplasty on account of the high incidence of urethral fistulas and stricture formation. 1,2 No method has become standardized so far. 2 We herein reported a successful preconstruction of the pars pendulans urethrae with digestive mucosa for phalloplasty in a one-arm patient using a prefabricated anterolateral thigh flap.…”

Sex reassignment surgery for transsexuals

“…With the advent of microsurgery, free flaps from forearm, fibula, thigh and latissimus dorsi muscle have been described [1,14].…”