Phalloplasty in female-to-male transsexuals by Gottlieb and Levine´s free radial forearm flap technique - A long-term single center experience over more than two decades

In many centers the free radial forearm (FRFF) phalloplasty represents the method of choice for penile reconstruction. Among the techniques described in literature, outcome measures for the flap design after Gottlieb and... [ view full abstract ]

In many centers the free radial forearm (FRFF) phalloplasty represents the method of choice for penile reconstruction. Among the techniques described in literature, outcome measures for the flap design after Gottlieb and Levine is poor.

The goal of the present study was to evaluate the postoperative outcome focusing on major and minor complications by adopting the technique of Gottlieb and Levine, since less representative data is available in current literature. [ view full abstract ]

The goal of the present study was to evaluate the postoperative outcome focusing on major and minor complications by adopting the technique of Gottlieb and Levine, since less representative data is available in current literature.

From January 1993 until December 2015 402 phalloplasties were performed in our department. Among the 247 FRFF phalloplasties, 232 FRFF phalloplasties were performed after the Gottlieb and Levine design in 229 patients.... [ view full abstract ]

From January 1993 until December 2015 402 phalloplasties were performed in our department. Among the 247 FRFF phalloplasties, 232 FRFF phalloplasties were performed after the Gottlieb and Levine design in 229 patients. Operation and patient specific characteristics’ were evaluated.

Patient characteristics and procedure specific data and complications were evaluated and interpreted. [ view full abstract ]

Patient characteristics and procedure specific data and complications were evaluated and interpreted.

To our knowledge this study presents the highest number of free radial forearm flap phalloplasties in Gottlieb and Levine´s design described so far in the literature. The rate total flap failure was 3%. 45,9% of the patients... [ view full abstract ]

To our knowledge this study presents the highest number of free radial forearm flap phalloplasties in Gottlieb and Levine´s design described so far in the literature. The rate total flap failure was 3%. 45,9% of the patients were heavy smokers. Urinary fistulas and strictures were common. The revision rate for urinary fistulas and/or strictures was 1.3 per patient. The number of postoperative complications, such as bleeding (14.2%), thrombosis of the flap requiring revision (11,2%) or delayed wound healing (16,8%) was considering the high rate of nicotine abuse (45.9%) reasonable.

The free radial forearm phalloplasty in the design by Gottlieb and Levine is well established at our institution and has proven safe an reliable since 1993. The operative results are satisfactory for both patients and surgeons... [ view full abstract ]

The free radial forearm phalloplasty in the design by Gottlieb and Levine is well established at our institution and has proven safe an reliable since 1993. The operative results are satisfactory for both patients and surgeons even in the presence of relevant comorbidities and heavy smoking. Therefore in our institution we continue to operate on smokers.