Tissue Engineering Approaches for Genital Reconstruction

Abstract

Genital reconstructive surgery is required for a wide variety intersex anomalies. One of the major limitations of phallic reconstructive surgery is the availability of sufficient autologous tissue. Non-genital autologous tissue sources have been used for decades. Phallic reconstruction was initially attempted in the late 1930s using rib cartilage as a stiffener in patients with traumatic penile loss (Ftumpkin et al, 1994; Goodwin et al, 1952) This method, involving multiple staged surgeries, was soon discouraged due the unsatisfactory functional and cosmetic results. Silicone rigid prostheses were popularized in the 1970s and have been used widely (Bretan et al, 1989; Small et al, 1975). However, biocompatibility issues have been a problem in selected patients (Nukui et al, 1997; Thonmalla et al, 1987). Tissue transfer techniques using flaps from various non-genital sources, such as the groin, dorsalis pedis and forearm, have been used for genital reconstruction (Jordan et al, 1999). However, operative complications, such as infection, graft failure and donor site morbidity are not negligible. Phallic reconstruction using autologous tissue, derived from the patient’s own cells, may be preferable in selected cases.