Primary and Secondary Reconstruction of the Neophallus Urethra
Neophalloplasty is one of the most difficult surgical procedures in genital reconstructive surgery. It is indicated in men where the penis is missing due to either congenital or acquired reasons, as well in women with gender dysphoria. Many different tissues have been applied such as local vascularized flaps or microvascular free transfer grafts. The main goal of the neophalloplasty is to construct the functional and cosmetically acceptable penis. Urethral reconstruction in neophalloplasty presents a great challenge for surgeons who manage genital reconstruction. Different flaps (penile skin, scrotal skin, abdominal skin, labial skin, vaginal flaps, etc.) or grafts (skin, bladder, buccal mucosa) have been suggested for urethral lengthening. Although serious complications were reported in the past, new techniques and modifications for primary and secondary neophallus urethroplasty seem to be safe in experienced hands.
KeywordsCatheter Ischemia Oxybutynin Hypospadias
This paper is supported by Ministry of Science, Republic of Serbia, Project No. 175048.
- 1.Bogoras N. Plastic construction of penis capable of accomplishing coitus. Zentral Chir. 1936;63:1271–6.Google Scholar
- 15.Johanson B. Reconstruction of the male urethra in strictures. Application of the buried intact epithelium tube. Acta Chir Scand. 1953;176:1.Google Scholar
- 16.Barbagli G, Palminteri E, De Stefani S, Lazzeri M. Penile urethroplasty. Techniques and outcomes using buccal mucosa grafts. Contemp Urol. 2006;18:25–33.Google Scholar
- 17.Lebovic GS, Laub DR. Metoidioplasty. In: Ehrlich RM, Alter GJ, editors. Reconstructive and plastic surgery of the external genitalia. Philadelphia: WB Saunders Co.; 1999. p. 355–60.Google Scholar
- 20.Djordjevic ML, Bizic M, Stanojevic D, Bumbasirevic M, Kojovic V, Majstorovic M, Acimovic M, Pandey S, Perovic SV. Urethral lengthening in metoidioplasty (female-to-male sex reassignment surgery) by combined buccal mucosa graft and labia minora flap. Urology. 2009;74:349–53.CrossRefPubMedGoogle Scholar