Because of the high rate of complications
and because voiding while standing is a priority for most female-to-male
transsexuals, until recently, I have refrained from implantation of a rigidity
prosthesis in total phalloplasty. However, promising results have been
obtained with self-contained Dynaflex hydraulic penile implants.
The results and complications observed in my
first five cases are reported in order to help prevent failure in future
cases. I advocate implantation as a secondary procedure after the neophallus
has gained sensitivity. The penile prosthesis should be covered by a Dacron
prosthesis to ensure optimal encapsulation and collagen ingrowth. Since the
neophallus girth will not allow for two prostheses to be implanted, and
because properly serviceable crus penis is lacking in female-to-male
transsexuals,
I further advocate fixation of the one
cylinder to the pubic symphysis. For insertion, the neoscrotal approach is
superior. I maintain that combination of a neourethra and a rigidity
prosthesis in one neophallus remains a challenge, both to the patient and to
the surgeon.
Citation:
Plast Reconstr Surg 1997 Feb;99(2):479-85 an article published on the Internet
by PubMed <http://www.ncbi.nlm.nih.gov/>
