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/>
