Purpose We present 5-year followup results of
patients who underwent total penile reconstruction with a prefabricated
lateral arm free flap technique.
Materials and Methods We treated 3
female-to-male transsexuals and a man with penile amputation with a 2-stage
technique of total penile reconstruction. In the first stage the neourethra
is constructed as a tubed skin graft incorporated in the territory of the
lateral arm flap. Three to 6 months later the lateral arm flap with its well
epithelialized conduit is fashioned into a penis, an inflatable prosthesis
is incorporated and the construction is transferred to the pubis with
vascular, urethral and nerve repairs.
Results In addition to the 2 surgical
procedures required to construct the penis, the patients have required an
average of 3 revisions. There were no complications beyond the first year
postoperatively. All 4 patients are able to void in the standing position
and are free of fistulas or strictures. The inflatable prosthesis allows
them to achieve penetration during sexual intercourse. All reconstructed
penises have recovered erogenous and tactile sensibility. Patient
satisfaction with the reconstructed penis is high. All transsexuals are
married and fully integrated as men.
Conclusions With the prefabricated lateral
arm free flap technique it is possible to achieve a fully functional penis
with stable long-term results and excellent patient satisfaction. To our
knowledge our series represents the first report of a technique for
functional penile reconstruction with at least 5 years of followup.
Citation:
J Urol 1998 Aug;160(2):383-8 an article published
on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
