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[Phalloplasty: Microsurgical options and management algorithm].

F Boucher1, S Brosset1, A A Mojallal1

  • 1Service de chirurgie plastique, reconstructrice et esthétique, hôpital de la Croix-Rousse, hospices Civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.

Annales De Chirurgie Plastique Et Esthetique
|May 1, 2017
PubMed
Summary
This summary is machine-generated.

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The radial forearm flap is the standard for penile reconstruction, but alternative microsurgical flaps like the anterolateral thigh perforator flap offer new options. A treatment algorithm guides the best choice for each patient.

Area of Science:

  • Reconstructive surgery
  • Microsurgery
  • Urology

Background:

  • The radial forearm flap is the established gold standard for penile reconstruction, offering excellent functional and aesthetic outcomes.
  • Donor site scarring can be a significant concern for transsexual patients undergoing phalloplasty.
  • Advancements in microsurgical techniques have introduced alternative flap options for penile reconstruction.

Purpose of the Study:

  • To discuss alternative microsurgical flap options for penile reconstruction.
  • To present a therapeutic algorithm for selecting the optimal flap based on patient and anatomical factors.
  • To highlight that satisfactory results can be achieved with procedures beyond the traditional radial forearm flap.

Main Methods:

  • Review and discussion of microsurgical flap techniques for penile reconstruction.
Keywords:
ALT flapLambeau antébrachialLambeau de latissimus dorsi à prélèvement partielLambeau perforant antérolatéral de cuisseMSLD flapMicrochirurgieMicrosurgeryPhalloplastiePhalloplastyRadial forearm flap

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  • Presentation of a therapeutic algorithm to guide flap selection.
  • Focus on pedicled anterolateral thigh perforator (ALT) flap and free muscle-sparing latissimus dorsi (MSLD) flap as alternatives.
  • Consideration of urethral reconstruction methods including free forearm flap, skin grafts, and buccal mucosa grafts.

    • Main Results:

    • The radial forearm flap remains a primary choice, but alternative flaps are viable when it's not feasible.
    • The pedicled ALT flap and free MSLD flap are presented as key alternatives.
    • Patient choice and local anatomical conditions are the most critical criteria for flap selection.
    • Urethral reconstruction can be successfully performed using various techniques.

    Conclusions:

    • Microsurgical phalloplasty offers diverse options beyond the radial forearm flap.
    • A structured therapeutic algorithm aids in selecting the most suitable procedure for individual patients.
    • Alternative flaps and reconstruction methods can yield satisfactory functional and aesthetic results in penile reconstruction.