Abstract
Total phalloplasty in transgender patients is the only option to create the penis large enough for successful intercourse. There are many different techniques described, but all of them have many weaknesses, providing less than satisfactory result. For this reason we tried to find better solution and choose the technique that use musculocutaneous latissimus dorsi flap.
It is a staged procedure with flap transfer in the first stage, urethroplasty in the second, and implantation of penile implants in the third. Implantation of testicular implants and glans-plasty are done in the second or third stage, when it is more suitable. We started with this approach 18 years ago and after slow evolution developed the present technique in the last 10 years. Aside from transsexual patients, it is also performed in all other patients who need penile reconstruction, such as trauma patients, patients with congenital micropenis, or patients with iatrogenic penile damage usually after epispadias or severe hypospadias repair.
Procedure is complex, staged, with long term between them, but in majority patients can provide satisfactory functional and esthetic outcome.
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Djinovic, R.P. (2015). Surgical Therapy: Total Phalloplasty Using Latissimus Dorsi Flap. In: Trombetta, C., Liguori, G., Bertolotto, M. (eds) Management of Gender Dysphoria. Springer, Milano. https://doi.org/10.1007/978-88-470-5696-1_31
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DOI: https://doi.org/10.1007/978-88-470-5696-1_31
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