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Michael Bickell, Jonathan Beilan, Jared Wallen, Lucas Wiegand, Rafael Carrion
This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation...
November 2016: Urologic Clinics of North America
Paul Neuville, Nicolas Morel-Journel, Delphine Maucourt-Boulch, Alain Ruffion, Philippe Paparel, Jean-Etienne Terrier
INTRODUCTION: The creation of a neophallus is a complex surgery that must meet functional and esthetic requirements. It is a long and demanding surgical process whose final stage consists of the implantation of a rigid or inflatable material that can be used to reproduce an erection. Data in the literature are scarce, with only the pioneering series present, which includes the use of the first devices and techniques. AIM: To report the outcome of patients with phalloplasty after implantation of erectile implants using standardized surgical techniques and the use of recent prosthesis types with or without a vascular graft...
September 29, 2016: Journal of Sexual Medicine
Britt Colebunders, Sam Brondeel, Salvatore D'Arpa, Piet Hoebeke, Stan Monstrey
INTRODUCTION: As gender dysphoria is becoming increasingly accepted in the general population, the number of patients seeking gender reassignment surgery is increasing. Although not every patient with gender dysphoria requires surgery, medical practitioners taking care of these individuals should be aware of the different surgical options. AIM: To review current gender reassignment surgical techniques and update the clinician. METHODS: A review of the literature was performed focusing on the most recent techniques of gender reassignment surgery...
September 10, 2016: Sexual Medicine Reviews
Shane D Morrison, Afaaf Shakir, Krishna S Vyas, Johanna Kirby, Curtis N Crane, Gordon K Lee
BACKGROUND: Acquired or congenital absence of the penis can lead to severe physical limitations and psychological outcomes. Phallic reconstruction can restore various functional aspects of the penis and reduce psychosocial sequelae. Moreover, some female-to-male transsexuals desire creation of a phallus as part of their gender transition. Because of the complexity of phalloplasty, there is not an ideal technique for every patient. This review sets out to identify and critically appraise the current literature on phalloplasty techniques and outcomes...
September 2016: Plastic and Reconstructive Surgery
Chao Chen, Ning Li, Yi-Ge Luo, Hong Wang, Xian-Ming Tang, Jia-Bo Chen, Chun-Qiang Dong, Qiang Liu, Kun Dong, Cheng Su, Ti-Quan Yang
PURPOSE: To evaluate the effect of modified penoplasty in the management of concealed penis. METHODS: We retrospectively reviewed 96 consecutive patients with concealed penis, which had been surgically corrected between July 2013 and July 2015. All patients underwent modified Shiraki phalloplasty. All patients were scheduled for regular follow-up at 1, 3, and 6 months after the surgery. Data on the patients' age, operative time, postoperative complications, and parents' satisfaction grade were collected and analyzed...
October 2016: International Urology and Nephrology
Christopher J Salgado, Ajani G Nugent, Alison M Moody, Harvey Chim, Alejandra M Paz, Hung-Chi Chen
BACKGROUND AND AIM: Radial forearm phalloplasty is accompanied by high rates of fistula formation. We examined the effect of placing a pedicled gracilis myofascial flap around the urethral anastomosis at the time of radial forearm flap transfer on the development of postoperative urethrocutaneous fistula. METHODS: Fifteen patients underwent phalloplasty with urethroplasty between June 2012 and October 2015, and they met the inclusion and exclusion criteria for the study...
June 2, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Anirban Majumder, Debmalya Sanyal
CONTEXT: Awareness of gender dysphoria (GD) and its treatment is increasing. There is paucity of scientific data from India regarding the therapeutic options being used for alleviating GD, which includes psychotherapy, hormone, and surgical treatments. AIM: To study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD. SETTINGS AND DESIGN: This is a retrospective study of treatment preferences and outcome in 18 female-to-male (FTM) transgender subjects who presented to the endocrine clinic...
May 2016: Indian Journal of Endocrinology and Metabolism
Miroslav L Djordjevic, Marta R Bizic, Dragana Duisin, Mark-Bram Bouman, Marlon Buncamper
INTRODUCTION: Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. AIMS: To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere...
June 2016: Journal of Sexual Medicine
Timothy J Tausch, Isamu Tachibana, Jordan A Siegel, Ronald Hoxworth, Jeremy M Scott, Allen F Morey
BACKGROUND: The authors present their experience with reconstructive strategies for men with various manifestations of adult buried penis syndrome, and propose a comprehensive anatomical classification system and treatment algorithm based on pathologic changes in the penile skin and involvement of neighboring abdominal and/or scrotal components. METHODS: The authors reviewed all patients who underwent reconstruction of adult buried penis syndrome at their referral center between 2007 and 2015...
September 2016: Plastic and Reconstructive Surgery
Ulrich M Rieger, Pawel Majenka, Anna Wirthmann, Michael Sohn, Ahmet Bozkurt, Gabriel Djedovic
OBJECTIVE: To improve the donor-site morbidity of the radial forearm flap through coverage with a free vascularized groin flap and comparing this flap coverage to the current standard, a full-thickness skin graft (FTSG). MATERIALS AND METHODS: A retrospective analysis of all free radial forearm flap phalloplasties for transgender surgery at our institution was performed. We examined patient characteristics, donor site defects, surgical procedure, and clinical courses...
September 2016: Urology
Lisi Xu, Muxin Zhao, Wen Chen, Yangqun Li, Zhe Yang, Ning Ma, Weixin Wang, Jun Feng, Qiyu Liu, Tong Ma
BACKGROUND: Our objective is to report on the efficacy and safety of dermal fat graft in augmentation phalloplasty performed on patients who presented complaining of "small penis," and evaluate the cosmetic and psychological outcomes of it. METHODS: From April 2010 and January 2015, 23 Chinese adult patients aged 18 to 33 years (average, 23 years) with subjective perception of small penis were included; all who requested an increase in the penile dimension underwent penile elongation (suprapubic skin advancement-ligamentolysis) and girth enhancement by dermal fat graft...
February 2016: Annals of Plastic Surgery
Anandev N Gurjala, Rahim S Nazerali, Ali Salim, Gordon K Lee
Techniques for neophallus reconstruction have become increasingly refined, fulfilling more criteria for what is considered to be the ideal penis reconstruction. For both trauma and transgender populations, the radial forearm free flap remains the gold standard, although the pedicled or free anterolateral thigh flap is becoming a favored alternative. Despite the remarkably high rates of sexual activity reported by patients having benefited from these techniques, sexual function remains a significant challenge due to frequent complications including autologous and prosthetic stiffener failure, fistula formation, and inadequate erogenous sensation...
May 2016: Annals of Plastic Surgery
Christopher J Salgado, Lydia A Fein, Jimmy Chim, Carlos A Medina, Stephanie Demaso, Christopher Gomez
Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM) transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts...
2016: Case Reports in Urology
Yang Zhe, Li Yangqun, Tang Yong, Zhao Muxin, Chen Wen, Ma Ning, Wang Weixin
OBJECTIVE: To introduce the application of pedicled anterolateral thigh (ALT) flap for total penile reconstruction and to investigate its feasibility and effect. METHODS: From May 2011 to May 2015, 12 male patients presented with absence of the penis or congenital malformation received phalloplasty with the pedicled ALT flap. Of them, the median age was 35 years old (range, 20-57 years). The size of the flaps ranged from 11 cm x 11 cm to 12 cm x 15 cm. 8 patients underwent urethra reconstruction with tube-in-tube flaps and other 4 patients with scrotal septal flaps...
November 2015: Zhonghua Zheng Xing Wai Ke za Zhi, Zhonghua Zhengxing Waike Zazhi, Chinese Journal of Plastic Surgery
Dogu Aydin, Liv Johanne Buk, Søren Partoft, Christian Bonde, Michael Vestergaard Thomsen, Tina Tos
INTRODUCTION: Gender dysphoria is a mismatch between a person's biological sex and gender identity. The best treatment is believed to be hormonal therapy and gender-confirming surgery that will transition the individual toward the desired gender. Treatment in Denmark is covered by public health care, and gender-confirming surgery in Denmark is centralized at a single-center with few specialized plastic surgeons conducting top surgery (mastectomy or breast augmentation) and bottom surgery (vaginoplasty or phalloplasty and metoidioplasty)...
April 2016: Journal of Sexual Medicine
Alessandro Thione, Pedro C Cavadas, Carlos G Rubi
Penile reconstruction is usually performed in patients with gender dysphoria; with penile loss because of trauma, infection, and tumors; and with congenital deformities like severe hypospadias, in which standard techniques do not achieve a good result. Hypospadias are one of the most common inherent genital anomalies in boys. Many surgical procedures have been published for total phallic reconstruction aiming at a functionally and aesthetically pleasing. We present a case of reconstruction of the penis in a severe hypospadias in a 40-year-old man by transferring the original glans to the forearm flap and a stiffening procedure with an osteocutaneous fibular flap 3 months after first surgery...
December 2015: Plastic and Reconstructive Surgery. Global Open
Diego Estevam Gomes Oliveira, Marcela Leal da Cruz, Riberto Liguori, Gilmar Garrone, Bruno Leslie, Sérgio Leite Ottoni, Geórgia Rubiane Souza, Valdemar Ortiz, Roberto de Castro, Antonio Macedo
OBJECTIVE: Aphallia is a rare penile congenital abnormality. The aim of this systematic review was to assess all available literature on neophalloplasty in infancy with an interest in technical alternatives and clinical outcome. MATERIALS AND METHODS: We performed a Pubmed search using the terms: neophalloplasty, neophallus, and phalloplasty, and selected articles that presented technical alternatives for penile construction in cases of penile dysgenesis, especially aphallia in children and/or adolescents...
February 2016: Journal of Pediatric Urology
Gabriele Antonini, Patrizio Vicini, Ettore De Berardinis, Arianna Pacchiarotti, Vincenzo Gentile, Paul Perito
Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life...
December 2015: Archivio Italiano di Urologia, Andrologia
Landon Trost, Philip Wanzek, George Bailey
Penile prostheses have remained the gold-standard therapy for medically refractory erectile dysfunction (ED) since their popularization. Advances in device design and surgical techniques have yielded improved rates of infection, satisfaction, and mechanical survival of devices. Operative techniques in penile prosthesis surgery include the use of adjunctive procedures (such as ventral phalloplasty and release of the suspensory ligament), management of penile fibrosis, and manoeuvres to correct Peyronie's-disease-related curvature...
January 2016: Nature Reviews. Urology
Shane D Morrison, Marcelina G Perez, Cayden K Carter, Curtis N Crane
Phalloplasty, or creation of the penis, is one of the steps in gender confirming surgery for a female-to-male patient and for males with absence or malformation of the penis. Here, the most common techniques for phalloplasty, along with the pre-operative and post-operative care are discussed.
May 2015: Urologic Nursing
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