Penile Reconstruction Versus Transplantation: Which One Is Ideal?
- 11 Downloads
Purpose of Review
Reconstruction of composite tissues or organs is challenging, with limited functional and esthetic outcomes. Nearly 100 years passed from the first penile reconstruction is performed; however, the outcomes were far from ideal. With the beginning of the reconstructive transplantation era, new choices became possible.
Until now, four penis transplantations were performed worldwide, with encouraging short-term results. Although with a short follow-up, these penile transplantations reported success. However, the problems related to systemic lifelong immunosuppression remain as the major problem related to these life-enhancing transplantations.
In this review, we revisit and evaluate the conventional methods of penis reconstruction, overview the up-to-date results of penis transplantation, and discuss advantages and disadvantages of these two techniques.
KeywordsVascularized composite allotransplantation Penile transplantation Penile reconstruction
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Remington AC, Morrison SD, Massie JP, Crowe CS, Shakir A, Wilson SC, et al. Outcomes after phalloplasty: do transgender patients and multiple urethral procedures carry a higher rate of complication? Plast Reconstr Surg. 2018;141(2):220e–9e. https://doi.org/10.1097/PRS.0000000000004061.CrossRefPubMedGoogle Scholar
- 3.Janak JC, Orman JA, Soderdahl DW, Hudak SJ. Epidemiology of genitourinary injuries among male U.S. service members deployed to Iraq and Afghanistan: early findings from the trauma outcomes and urogenital health (TOUGH) project. J Urol. 2017;197(2):414–9. https://doi.org/10.1016/j.juro.2016.08.005.CrossRefPubMedGoogle Scholar
- 5.Nnamani NS, Janak JC, Hudak SJ, Rivera JC, Lewis EA, Soderdahl DW, et al. Genitourinary injuries and extremity amputation in operations enduring freedom and Iraqi freedom: early findings from the trauma outcomes and urogenital health (TOUGH) project. J Trauma Acute Care Surg. 2016;81(5 Suppl 2 Proceedings of the 2015 Military Health System Research Symposium):S95–S9. https://doi.org/10.1097/TA.0000000000001122.CrossRefPubMedGoogle Scholar
- 8.• Morrison SD, Shakir A, Vyas KS, Kirby J, Crane CN, Lee GK. Phalloplasty: a review of techniques and outcomes. Plast Reconstr Surg. 2016;138(3):594–615. https://doi.org/10.1097/PRS.0000000000002518 This study is an updated rewiew of the surgical techniques used in penile reconstruction.CrossRefPubMedGoogle Scholar
- 9.Cetrulo CL Jr, Li K, Salinas HM, Treiser MD, Schol I, Barrisford GW, et al. Penis transplantation: first US experience. Ann Surg. 2017:1. https://doi.org/10.1097/SLA.0000000000002241.
- 17.Sengezer M, Zor F. Penile reconstruction with free sensate osteocutaneous fibula flap in female-to-male gender reassignment surgery. Turkiye Klinikleri J Plast Surg-Special Topics. 2016;5(3):71–7.Google Scholar
- 21.Yang M, Zhao M, Li S, Li Y. Penile reconstruction by the free scapular flap and malleable penis prosthesis. Ann Plast Surg. 2007;59(1):95–101. https://doi.org/10.1097/01.sap.0000253745.07940.da.CrossRefPubMedGoogle Scholar
- 25.•• van der Merwe A, Graewe F, Zuhlke A, Barsdorf NW, Zarrabi AD, Viljoen JT, et al. Penile allotransplantation for penis amputation following ritual circumcision: a case report with 24 months of follow-up. Lancet. 2017;390(10099):1038–47. https://doi.org/10.1016/S0140-6736(17)31807-X This study reports the 24-month follow-up result of the a penile transplant patient, which is the longest follow-up currently. CrossRefPubMedGoogle Scholar
- 26.First-Ever Penis and Scrotum Transplant Makes History at Johns Hopkins. 2018; Available from: https://www.hopkinsmedicine.org/news/articles/first-ever-penis-and-scrotum-transplant-makes-history-at-johns-hopkins.
- 27.Tuffaha SH, Sacks JM, Shores JT, Brandacher G, Lee WP, Cooney DS, et al. Using the dorsal, cavernosal, and external pudendal arteries for penile transplantation: technical considerations and perfusion territories. Plast Reconstr Surg. 2014;134(1):111e–9e. https://doi.org/10.1097/PRS.0000000000000277.CrossRefPubMedGoogle Scholar