Phalloplasty Flap-Related Complication

Esmonde, Nick O.; Bluebond-Langner, Rachel; Berli, Jens U.

doi:10.1016/j.cps.2018.03.017

Cited by 38 publications

(43 citation statements)

References 11 publications

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“…An example of partial flap loss in radial forearm free flap phalloplasty at the distal radial aspect of the flap. A: debridement of the flap and placement of Integra (Integra, Princeton, NJ); B: status post full thickness skin graft (FTSG); C: healed appearance following FTSG [34,35] A C B Figure 6. Appearance at the second stage of a Big Ben style two-stage phalloplasty.…”

Section: Resultsmentioning

confidence: 99%

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Partial flap loss in transgender phalloplasty using the anterolateral thigh or forearm - a systematic literature review

2020

Plast Aesthet Res

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Aim: In this study, we systematically review the current literature regarding partial flap loss (PFL) for the two most commonly performed types of phalloplasty, the radial forearm and the anterolateral thigh flaps. The primary purpose is to synthesize the available information to clarify anatomic location, etiology, extent of flap loss, and management thereof. Second, we utilize this information to inform strategies to mitigate the risk of PFL. Methods: A systematic review of all abstracts published on phalloplasty on PubMed was performed. Abstracts were reviewed by two senior authors who included all studies discussing flap-related outcomes after radial forearm free flap (RFFF) phalloplasty or anterolateral thigh flap (ALT) phalloplasty for the treatment of gender dysphoria. Primary variables collected include: flap type, PFL rate, anatomic location, extent of and management of PFL.

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Section: Resultsmentioning

confidence: 99%

“…After stage two, the patient developed a fistula that was amenable to outpatient repair; voiding now and has received a semi-malleable implant. A: visible ischemic urethral flap; B: status post marsupialization at a more superior location [35] A B…”

Section: Resultsmentioning

confidence: 99%

Partial flap loss in transgender phalloplasty using the anterolateral thigh or forearm - a systematic literature review

2020

Plast Aesthet Res

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“…We have published previously on this topic (11). While complications with phalloplasty are not a fait accompli, we encourage this mindset as it allows the surgeon to think more proactively and preventatively during the multiple reconstructive steps.…”

Section: Management Of Flap Related Complicationsmentioning

confidence: 90%

Phalloplasty: techniques and outcomes

Heston¹,

Esmonde²,

Dugi³

et al. 2019

Transl. Androl. Urol

105

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Phalloplasty is an exceptionally complicated reconstructive procedure that attempts to create a structure that is penis-like. As patient goals vary widely, it is helpful to think about phalloplasty as a modular set of procedures that can be combined, mixed and matched to meet the needs of each individual patient while also taking into account their anatomy. Each module-but particularly the shaft and penile urethracan be performed using a variety of techniques. To date, there is no consensus among surgeons regarding the optimum staging of the reconstructive steps. Our primary goal is to outline the most frequently performed and reported options in phallic reconstruction and outline the various considerations that go into choosing a given sequence of procedures for the specific patient. The secondary goal of this article is to describe the complications common to each of those modules and how they interact when combined.

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“…In general, patients with RFFF phalloplasty have fewer urethral strictures and fistulas than those with ALT phalloplasty (38,39). Neophallus flap specific complications are fortunately low, with partial (<8%) and complete (<2%) flap loss rates decreasing as surgeon experience widens (40).…”

Section: Penile Revascularization/transplantation/phalloplastymentioning

confidence: 99%