Urethroplasty in Phalloplasty: Surgical Outcomes and Complications a Critical Review

  • Afonso Morgado Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal
  • Nuno Tomada Departamento de Doenças Renais, Urológicas e Infecciosas, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal

Abstract

Phalloplasty can be either performed as a penile reconstructive or phallic constructive procedure, mainly in penile trauma victims or female-to-male gender reassignment. After the introduction of the radial artery-based forearm free flap and with the further awareness of patient desire to void while standing, urethral reconstruction became a standard procedure and a main goal to attain in phalloplasty. Urethroplasty techniques can be broadly split in two main groups: as part of a tube-within-a-tube skin flap or as an independent other-than-skin graft. Urethral complications, such as fistula, stricture, or stones, are common and often recur after treatment. In this review, the main techniques of urethral reconstruction in phalloplasty are reviewed and compared. Urethral complications are also reviewed as well as their management.

References

1. Chang TS, Hwang WY. Forearm flap in one-stage reconstruction of the
penis. Plast Reconstr Surg. 1984;74:251-8.

2. Hage JJ, Bout CA, Bloem JJ, Megens JA. Phalloplasty in female-to-male
transsexuals: what do our patients ask for? Ann Plast Surg. 1993;30:323-6.

3. Rashid M, Sarwar SU. Avulsion injuries of the male external genitalia: classification
and reconstruction with the customized radial forearm free flap.
Br J Plast Surg. 2005;58:585-92.

4. Bettocchi C, Ralph DJ, Pryor JP. Pedicled pubic phalloplasty in females
with gender dysphoria. BJU Int. 2005;95:120-4.

5. Garaffa G, Christopher NA, Ralph DJ. Total phallic reconstruction in female-
to-male transsexuals. Eur Urol. 2010;57:715-22.

6. Liu CY, Wei ZR, Jiang H, Zhao YZ, Zhang YF. Preconstruction of the pars
pendulans urethrae for phalloplasty with digestive mucosa using a prefabricated
anterolateral thigh flap in a one-arm patient. Plast Reconstr Surg
Glob Open. 2013;1:e53.

7. Leriche A, Timsit MO, Morel-Journel N, Bouillot A, Dembele D, Ruffion A.
Long-term outcome of forearm flee-flap phalloplasty in the treatment of
transsexualism. BJU Int. 2008;101:1297-300.

8. Garaffa G, Raheem AA, Christopher NA, Ralph DJ. Total phallic reconstruction
after penile amputation for carcinoma. BJU Int. 2009;104:852-6.

9. Perovic S. Phalloplasty in children and adolescents using the extended
pedicle island groin flap. J Urol. 1995;154:848-53.

10. Rashid M, Aslam A, Malik S, Tamimy MS, Ehtesham ul H, Aman S, et al.
Clinical applications of the pedicled anterolateral thigh flap in penile reconstruction.
J Plast Reconstr Aesthet Surg. 2011;64:1075-81.

11. Papadopulos NA, Schaff J, Biemer E. The use of free prelaminated and
sensate osteofasciocutaneous fibular flap in phalloplasty. Injury. 2008;39
Suppl 3:S62-7.

12. Kim SK, Moon JB, Heo J, Kwon YS, Lee KC. A new method of urethroplasty
for prevention of fistula in female-to-male gender reassignment surgery.
Ann Plast Surg. 2010;64:759-64.
Published
2017-07-20
How to Cite
MORGADO, Afonso; TOMADA, Nuno. Urethroplasty in Phalloplasty: Surgical Outcomes and Complications a Critical Review. Acta Urológica Portuguesa, [S.l.], v. 34, n. 1-2, p. 40-44, july 2017. ISSN 2387-0419. Available at: <http://www.actaurologicaportuguesa.com/index.php/aup/article/view/8>. Date accessed: 18 oct. 2017.