Anterolateral thigh phalloplasty: Prefabricating urethra technique

The radial forearm free flap has been considered the best procedure for neophallus reconstruction for many years, but other flaps have been attempted to minimize donor site morbidity and optimize outcome. The pedicled... [ view full abstract ]

The radial forearm free flap has been considered the best procedure for neophallus reconstruction for many years, but other flaps have been attempted to minimize donor site morbidity and optimize outcome. The pedicled anterolateral thigh flap is considered to be reliable and to decrease the risks of total flap failure.

To describe the surgical procedure of pedicled ALT (anterolateral thigh) flap phalloplasty in female-to-male transsexuals. [ view full abstract ]

To describe the surgical procedure of pedicled ALT (anterolateral thigh) flap phalloplasty in female-to-male transsexuals.

We report successful total phallic reconstruction in a female-to-male transsexual patient using an island pedicled anterolateral thigh (ALT) flap. The procedure involved 2 stages operation; the first stage consisting of total... [ view full abstract ]

We report successful total phallic reconstruction in a female-to-male transsexual patient using an island pedicled anterolateral thigh (ALT) flap. The procedure involved 2 stages operation; the first stage consisting of total vaginectomy, urethral lengthening, and prefabricating urethra. The second stage consisted pedicled ALT flap, nerves anastomosis, and urethral anastomosis.

Between April 2013 and April 2016, there were 23 cases of female-to-male performed at our hospital. Five cases were performed with two flaps technique (Free Radial forearm flap with ALT flaps), Eighteen cases were performed... [ view full abstract ]

Between April 2013 and April 2016, there were 23 cases of female-to-male performed at our hospital. Five cases were performed with two flaps technique (Free Radial forearm flap with ALT flaps), Eighteen cases were performed with prefabricating urethra.

The neophallus shows aesthetically appealing results. The operative time was approximately 6-8 hours. Hospitalization time was 14 days. The urine catheter was retained in 3 weeks postoperatively. The patient was able to... [ view full abstract ]

The neophallus shows aesthetically appealing results. The operative time was approximately 6-8 hours.
Hospitalization time was 14 days. The urine catheter was retained in 3 weeks postoperatively.
The patient was able to urinate without urethral fistula.

We consider this technique for phalloplasty concerning effort, complications, donor site morbidity and aesthetic result as an appropriate alternative to established methods in selected patients. Additionally the shortened... [ view full abstract ]

We consider this technique for phalloplasty concerning effort, complications, donor site morbidity and aesthetic result as an appropriate alternative to established methods in selected patients. Additionally the shortened operating time and the lack of possible complications of microvascular anastomoses bear advantages. The pedicled ALT flap may be a reliable option to avoid visible scarring at the donor site on exposed body parts.