A unique case of secondary microvascular glansplasty: the last genitoreconstructive frontier?

Isolated amputation of the noncarcinogenic penile glans is an extremely rare event. Immediate replantation as a composite graft or by microvascular techniques is the treatment of choice. Secondary reconstruction of the penile glans may be indicated after necrosis as a sequela of infection, surgical resection for malignancy, traumatic loss, and self-mutilation. To date, reported surgical techniques of glanular reconstruction have only been described as part of total phalloplasty. Secondary reconstruction of the penile glans using a sensate radial forearm free flap was performed in a 28-year-old man who presented 3 years after self-amputation in a psychotic state.