Double flap phalloplasty in transgender men: Surgical technique and outcome of pedicled anterolateral thigh flap phalloplasty combined with radial forearm free flap urethral reconstruction.
Microsurgery
; 37(8): 917-923, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28556461
ABSTRACT
INTRODUCTION:
Radial forearm free flap (RFFF) tube-in-tube phalloplasty is the most performed phalloplasty technique worldwide. The conspicuous donor-site scar is a drawback for some transgender men. In search for techniques with less conspicuous donor-sites, we performed a series of one-stage pedicled anterolateral thigh flap (ALT) phalloplasties combined with RFFF urethral reconstruction. In this study, we aim to describe this technique and assess its surgical outcome in a series of transgender men. PATIENTS ANDMETHODS:
Between January 2008 and December 2015, nineteen transgender men (median age 37, range 21-57) underwent pedicled ALT phalloplasty combined with RFFF urethral reconstruction in one stage. The surgical procedure was described. Patient demographics, surgical characteristics, intra- and postoperative complications, hospitalization length, and reoperations were recorded.RESULTS:
The size of the ALT flaps ranged from 12 × 12 to 15 × 13 cm, the size of the RFFFs from 14 × 3 to 17 × 3 cm. Median clinical follow-up was 35 months (range 3-95). Total RFFF failure occurred in two patients, total ALT flap failure in one patient, and partial necrosis of the ALT flap in one patient. Long-term urinary complications occurred in 10 (53%) patients, of which 9 concerned urethral strictures.CONCLUSIONS:
In experienced hands, one-stage pedicled ALT phalloplasty combined with RFFF urethral reconstruction is a feasible alternative surgical option in eligible transgender men, who desire a less conspicuous forearm scar. Possible drawbacks comprise flap-related complications, difficult inner flap monitoring and urethral complications.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pênis
/
Retalhos Cirúrgicos
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Transexualidade
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Uretra
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Procedimentos de Cirurgia Plástica
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Cirurgia de Readequação Sexual
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Microsurgery
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Holanda