Total urethral construction with the radial artery-based forearm free flap in the transsexual
Giulio Garaffa1, David J Ralph, Nim Christopher
1St Peter's Andrology Centre and the Institute of Urology, London, UK.
Objective:
to report our experience of using a radial artery-based forearm free flap urethroplasty (RAFFFU) inside a pre-fashioned pedicled pubic phalloplasty for female-to-male gender reassignment.
Patients And Methods:
a neourethra based on the RAFFF was incorporated into a previously constructed phalloplasty in 27 patients. Surgical outcome, patients' satisfaction and voiding sensation of the neourethra were subjectively and prospectively assessed by direct questioning during the follow-up.
Results:
after a median follow-up of 9.2 months, all patients who completed the two stages of the procedure were able to void from the tip of the phallus while standing. Donor-site morbidity was minimal, with all patients reporting a complete recovery of forearm sensation and mobility. The overall satisfaction rate was 92%.
Conclusions:
the RAFFFU is the best technique of total urethral construction in female-to-male transsexuals who opt not to undergo a RAFFF phalloplasty.
