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Phalloplasty following penectomy for penile cancer

OBJECTIVE: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex surgical techniques required. This narrative review d...

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Autores principales: Lee, Wai Gin, Christopher, A. Nim, Ralph, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Second Military Medical University 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643302/
https://www.ncbi.nlm.nih.gov/pubmed/36381591
http://dx.doi.org/10.1016/j.ajur.2022.05.005
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author Lee, Wai Gin
Christopher, A. Nim
Ralph, David J.
author_facet Lee, Wai Gin
Christopher, A. Nim
Ralph, David J.
author_sort Lee, Wai Gin
collection PubMed
description OBJECTIVE: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex surgical techniques required. This narrative review describes the technical concepts and summarises the contemporary outcomes following phalloplasty in this challenging cohort. METHODS: A retrospective review of the English literature was performed between January 1946 till November 2021. The data were synthesised and complemented by the expert opinion of the authors with 20 years of experience in this field. The flaps are ideally designed with an integrated urethra or alternatively, a further free flap urethroplasty can be offered. Phalloplasty is further complicated following penectomy by scarring from the previous surgery and the potential loss of structures that would normally be present at the recipient site. RESULTS: There are limited published data with a total of 19 men recorded in the literature. Only the radial artery forearm free flap and anterolateral thigh flap have been described in this cohort of patients. Functional outcomes including standing micturition, sensation in the neophallus, and the ability to orgasm are good. Overall quality of life and satisfaction was also good despite the high risk for long-term complications of the neophallus and donor site. CONCLUSION: Phalloplasty following penectomy requires microsurgical transfer of a free flap or a pedicled flap to reconstruct a neophallus. An erectile device is inserted at a later stage to facilitate sexual intercourse, if desired. Surgical scarring from penectomy and the potential loss of vasculature that would normally be present at the recipient site may further complicate reconstruction. Surgical and functional outcomes are acceptable based on the limited published experience to date.
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spelling pubmed-96433022022-11-14 Phalloplasty following penectomy for penile cancer Lee, Wai Gin Christopher, A. Nim Ralph, David J. Asian J Urol Review OBJECTIVE: Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual intercourse. Phalloplasty is usually staged due to the complex surgical techniques required. This narrative review describes the technical concepts and summarises the contemporary outcomes following phalloplasty in this challenging cohort. METHODS: A retrospective review of the English literature was performed between January 1946 till November 2021. The data were synthesised and complemented by the expert opinion of the authors with 20 years of experience in this field. The flaps are ideally designed with an integrated urethra or alternatively, a further free flap urethroplasty can be offered. Phalloplasty is further complicated following penectomy by scarring from the previous surgery and the potential loss of structures that would normally be present at the recipient site. RESULTS: There are limited published data with a total of 19 men recorded in the literature. Only the radial artery forearm free flap and anterolateral thigh flap have been described in this cohort of patients. Functional outcomes including standing micturition, sensation in the neophallus, and the ability to orgasm are good. Overall quality of life and satisfaction was also good despite the high risk for long-term complications of the neophallus and donor site. CONCLUSION: Phalloplasty following penectomy requires microsurgical transfer of a free flap or a pedicled flap to reconstruct a neophallus. An erectile device is inserted at a later stage to facilitate sexual intercourse, if desired. Surgical scarring from penectomy and the potential loss of vasculature that would normally be present at the recipient site may further complicate reconstruction. Surgical and functional outcomes are acceptable based on the limited published experience to date. Second Military Medical University 2022-10 2022-08-03 /pmc/articles/PMC9643302/ /pubmed/36381591 http://dx.doi.org/10.1016/j.ajur.2022.05.005 Text en © 2022 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review
Lee, Wai Gin
Christopher, A. Nim
Ralph, David J.
Phalloplasty following penectomy for penile cancer
title Phalloplasty following penectomy for penile cancer
title_full Phalloplasty following penectomy for penile cancer
title_fullStr Phalloplasty following penectomy for penile cancer
title_full_unstemmed Phalloplasty following penectomy for penile cancer
title_short Phalloplasty following penectomy for penile cancer
title_sort phalloplasty following penectomy for penile cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643302/
https://www.ncbi.nlm.nih.gov/pubmed/36381591
http://dx.doi.org/10.1016/j.ajur.2022.05.005
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