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Penile reconstruction with the radial forearm flap: an update
M Doornaert1, P Hoebeke, P Ceulemans
1Department of Plastic Surgery, Gent University Hospital, Belgium.
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|August 13, 2011
Summary
The radial forearm flap is a reliable phalloplasty technique for penile reconstruction, offering good aesthetic and functional outcomes. While not without drawbacks like scarring and potential complications, it enables standing voiding and sexual satisfaction.
Area of Science:
- Reconstructive Surgery
- Urology
- Microsurgery
Background:
- Phalloplasty aims for ideal penile reconstruction, but no single technique perfectly achieves all goals.
- The radial forearm flap is the most common method, widely regarded as the current standard of care.
Purpose of the Study:
- To critically evaluate the radial forearm flap's suitability as the gold standard in penile reconstruction.
- To assess its ability to meet the requirements of an ideal penile reconstruction based on extensive data.
Main Methods:
- Retrospective analysis of 316 radial forearm phalloplasties performed by a single surgical team since 1992.
- Evaluation of outcome parameters including functional results, aesthetics, sensation, voiding, donor site morbidity, and sexual function.
Main Results:
- The radial forearm flap is a reliable technique for creating a natural-looking penis and scrotum.
- Full functionality requires a minimum of two procedures; patients can void standing and achieve sexual satisfaction.
- Disadvantages include forearm scarring, initial urinary fistulas, potential long-term urological issues, and the need for an erection prosthesis.
Conclusions:
- While prospective studies are lacking, retrospective data support the radial forearm flap's reliability in phalloplasty.
- Multidisciplinary collaboration between reconstructive plastic surgeons and urologists is crucial for optimal outcomes.
- The technique offers a viable solution for penile reconstruction despite its limitations.