Thinking outside the box: Alternative techniques for gender affirming phalloplasty

Area of Science:

• Genitourinary reconstructive surgery
• Gender affirmation surgery
• Surgical techniques

Background:

• Gender affirmation surgery, including phalloplasty, is increasingly common.
• Surgical techniques for phalloplasty are continuously evolving.
• Phalloplasty is a complex procedure with various influencing factors.

Purpose of the Study:

• To present lesser-known and infrequently performed phalloplasty methods.
• To discuss alternative phalloplasty techniques in gender-affirming care.

Main Methods:

• Literature review of case series and comprehensive articles.
• Description of obscure and less frequently utilized flaps for phalloplasty.

Main Results:

• The radial forearm free flap is the most common technique.
• Numerous alternative phalloplasty options exist.
• Limited outcomes data hinders the establishment of a standard of care.

Conclusions:

• Phalloplasty goals include standing urination, intercourse, sensation, aesthetics, and minimal donor site morbidity.
• A definitive standard of care for phalloplasty has not yet been established.
• Continued innovation may lead to more reliable phalloplasty options.