Total phallic reconstruction after penile amputation for carcinoma.

Area of Science:

• Reconstructive surgery
• Urology
• Microsurgery

Background:

• Subtotal penectomy for penile or urethral cancer necessitates phallic reconstruction.
• Total phallic reconstruction (TPR) aims to restore function and cosmesis.
• Radial-artery free flap (RAFF) is a reconstructive option.

Purpose of the Study:

• To evaluate the efficacy of RAFF for TPR in patients with penile or urethral cancer.
• To assess cosmetic and functional outcomes, including neourethra creation and penile implant insertion.
• To determine patient satisfaction and complication rates.

Main Methods:

• Retrospective review of 15 patients undergoing RAFF TPR (January 1998 - May 2008).
• Assessment of surgical outcomes, phallic cosmesis, complications, revision needs, and patient satisfaction.
• Follow-up data collected on voiding, sexual function, and prosthesis use.

Main Results:

• All patients achieved a cosmetically acceptable phallus.
• 14/15 patients could void standing; 5/7 with penile implants resumed sexual intercourse.
• Common complications included urethral strictures (3) and fistulae (4); one prosthesis infection led to explantation.

Conclusions:

• RAFF phalloplasty is a highly effective technique for total phallic reconstruction.
• It yields excellent cosmetic and functional results, significantly improving patient quality of life.
• The procedure facilitates functional voiding and sexual activity restoration.