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Penile Prosthesis in Transgender Men after Phalloplasty
Rajveer S Purohit1, Marissa Kent1, Miroslav L Djordjevic1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Summary
Penile prosthesis implantation in transgender men is possible but carries high risks due to anatomical differences. Surgeons must counsel patients on the significant likelihood of needing revision surgery after phalloplasty.
Area of Science:
- Urology
- Gender-affirming surgery
Background:
- Penile prostheses are used after phalloplasty in transgender men to enable sexual intercourse.
- Inflatable prostheses are common but associated with high complication rates.
Purpose of the Study:
- To review the challenges and outcomes of penile prosthesis implantation in transgender men.
- To highlight differences compared to cisgender patients and associated risks.
Main Methods:
- Review of existing literature and case reports on penile prosthesis implantation in transgender men.
- Analysis of anatomical differences impacting device placement and retention.
Main Results:
- Transgender patients lack the protective tunica albuginea, increasing device mobility, migration, and erosion risks.
- Bone anchoring is necessary due to the absence of corpora cavernosa.
- Complications include urethral/vascular injury, infection, device failure, and erosion.
Conclusions:
- Successful penile prosthesis implantation can enhance quality of life for transgender men.
- High complication and revision surgery rates necessitate thorough patient counseling regarding risks.
