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Long-Term Urologic Outcomes Using the Big Ben Method for Phalloplasty.

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  • 1From the Division of Plastic and Reconstructive Surgery.

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Summary

The "Big Ben Method" for urethral lengthening in phalloplasty shows promise in reducing stricture rates and improving patient satisfaction. This two-stage approach facilitates standing urination with manageable complication rates.

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Area of Science:

  • Urology
  • Gender-affirming surgery
  • Microsurgery

Background:

  • Phalloplasty techniques for urethral construction vary, complicating outcome comparisons.
  • High rates of urologic complications are a frequent concern in phalloplasty.
  • Standardizing surgical methods is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the long-term outcomes of the
  • Methods
  • The "Big Ben Method" two-A stage method for urethral lengthening was employed in 73 patients between December 2016 and September 2023, with a minimum of 6 months follow-up.
  • Surgical outcomes, including urethral fistulas and strictures, were evaluated.
  • Patient-reported outcome measures were collected via surveys.

Main Methods:

  • Retrospective study design.
  • Single surgeon.
  • Utilized the "Big Ben Method" two-stage surgical technique for urethral lengthening.
  • Long-term follow-up (≥6 months) for 73 patients.

Main Results:

  • 96% of patients achieved successful standing urination after the second stage.
  • Urethral stricture rate was 8% and urethro-cutaneous fistula rate was 16.4% among those who completed the second stage.
  • High patient satisfaction reported, with 96% willing to undergo the procedure again.

Conclusions:

  • The "Big Ben Method" shows potential for reducing urethral stricture rates in phalloplasty.
  • This technique may mitigate the severity and impact of complications on quality of life.
  • The procedure is well-suited for academic, multidisciplinary settings and achieves high patient satisfaction.