Phalloplasty for an amputated phallus in intersex patients

OBJECTIVE: To report our experience of phalloplasty using a radial forearm free-flap (RFF) and insertion of a penile prosthesis for the amputated phallus. PATIENTS AND METHODS: Phalloplasty was carried out in nine intersex patients with ambiguous genitalia as a result of female circumcision, with a consequent partial or complete excision of their microphallus. Six months later a penile prosthesis was inserted in the periostium of the lower border of the symphysis pubis in the first six patients. RESULTS: All patients were fully satisfied with the size and cosmetic appearance of their penis. One patient had a urinary fistula that was closed surgically. All of the patients are continent. The penile prosthesis was implanted successfully with no complications. CONCLUSIONS: Phalloplasty using a RFF and insertion of a penile prosthesis for the amputated phallus are technically feasible, with good clinical and functional outcomes.