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Semin Plast Surg 2011; 25(3): 221-228
DOI: 10.1055/s-0031-1281492
© Thieme Medical Publishers

Penile Reconstruction

Christopher J. Salgado1 , Harvey Chim2 , Jennifer C. Tang1 , Stan J. Monstrey3 , Samir Mardini4
  • 1Division of Plastic Surgery, Miller School of Medicine, University of Miami, Miami, Florida
  • 2Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio
  • 3Department of Plastic Surgery, University Hospital Gent, Gent, Belgium
  • 4Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
Further Information

Publication History

Publication Date:
03 September 2011 (online)

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ABSTRACT

A variety of surgical options exists for penile reconstruction. The key to success of therapy is holistic management of the patient, with attention to the psychological aspects of treatment. In this article, we review reconstructive modalities for various types of penile defects inclusive of partial and total defects as well as the buried penis, and also describe recent basic science advances, which may promise new options for penile reconstruction.

KEYWORDS

Dyspareunia - penile reconstruction - osteocutaneous flaps - radial forearm flap - penile cancer - priapism - micropenis - phallus - penis

REFERENCES

  • 1 Schonfeld W, Beebe G W. Normal growth and variation in the male genitalia from birth to maturity.  J Urol. 1942;  48 759
    CrossrefPubMedGoogle Scholar
  • 2 Spyropoulos E, Borousas D, Mavrikos S, Dellis A, Bourounis M, Athanasiadis S. Size of external genital organs and somatometric parameters among physically normal men younger than 40 years old.  Urology. 2002;  60 (3) 485-489 discussion 490-491
    CrossrefPubMedGoogle Scholar
  • 3 Amukele S A, Lee G W, Stock J A, Hanna M K. 20-year experience with iatrogenic penile injury.  J Urol. 2003;  170 (4 Pt 2) 1691-1694
    CrossrefPubMedGoogle Scholar
  • 4 Ghanem H, Shamloul R, Khodeir F, ElShafie H, Kaddah A, Ismail I. Structured management and counseling for patients with a complaint of a small penis.  J Sex Med. 2007;  4 (5) 1322-1327
    CrossrefPubMedGoogle Scholar
  • 5 Alter G J. Penile enlargement surgery.  Tech Urol. 1998;  4 (2) 70-76
    PubMedGoogle Scholar
  • 6 Zhao Y Q, Zhang J, Yu M S, Long D C. Functional restoration of penis with partial defect by scrotal skin flap.  J Urol. 2009;  182 (5) 2358-2361
    CrossrefPubMedGoogle Scholar
  • 7 Mazza O N, Cheliz G M. Glanuloplasty with scrotal flap for partial penectomy.  J Urol. 2001;  166 (3) 887-889
    CrossrefPubMedGoogle Scholar
  • 8 Salgado C J, Chim H, Rowe D, Bodner D R. Vascularized cadaveric fibula flap for treatment of erectile dysfunction following failure of penile implants.  J Sex Med. 2010;  7 (10) 3504-3509
    CrossrefPubMedGoogle Scholar
  • 9 Micheli E, Ranieri A, Peracchia G, Lembo A. End-to-end urethroplasty: long-term results.  BJU Int. 2002;  90 (1) 68-71
    CrossrefPubMedGoogle Scholar
  • 10 Guralnick M L, Webster G D. The augmented anastomotic urethroplasty: indications and outcome in 29 patients.  J Urol. 2001;  165 (5) 1496-1501
    CrossrefPubMedGoogle Scholar
  • 11 El-Kassaby A W, El-Zayat T M, Azazy S, Osman T. One-stage repair of long bulbar urethral strictures using augmented Russell dorsal strip anastomosis: outcome of 234 cases.  Eur Urol. 2008;  53 (2) 420-424
    CrossrefPubMedGoogle Scholar
  • 12 Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique?.  J Urol. 2005;  174 (3) 955-957 discussion 957-958
    CrossrefPubMedGoogle Scholar
  • 13 Nuhu A, Edino S T, Agbese G O, Kallamu M. Penile gangrene due to strangulation by a metallic nut: a case report.  West Afr J Med. 2009;  28 (5) 340-342
    PubMedGoogle Scholar
  • 14 Gyan S, Sushma S, Maneesh S, Rajesh S, Misra M. Successful microsurgical penile replantation following self amputation in a schizophrenic patient.  Indian J Urol. 2010;  26 (3) 434-437
    CrossrefPubMedGoogle Scholar
  • 15 Puckett C L, Montie J E. Construction of male genitalia in the transsexual, using a tubed groin flap for the penis and a hydraulic inflation device.  Plast Reconstr Surg. 1978;  61 (4) 523-530
    CrossrefPubMedGoogle Scholar
  • 16 Chang T S, Hwang W Y. Forearm flap in one-stage reconstruction of the penis.  Plast Reconstr Surg. 1984;  74 (2) 251-258
    CrossrefPubMedGoogle Scholar
  • 17 Garaffa G, Christopher N A, Ralph D J. Total phallic reconstruction in female-to-male transsexuals.  Eur Urol. 2010;  57 (4) 715-722
    CrossrefPubMedGoogle Scholar
  • 18 Monstrey S, Hoebeke P, Selvaggi G et al.. Penile reconstruction: is the radial forearm flap really the standard technique?.  Plast Reconstr Surg. 2009;  124 (2) 510-518
    CrossrefPubMedGoogle Scholar
  • 19 Song C, Wong M, Wong C H, Ong Y S. Modifications of the radial forearm flap phalloplasty for female-to-male gender reassignment.  J Reconstr Microsurg. 2011;  27 (2) 115-120
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Monstrey S, Hoebeke P, Dhont M et al.. Radial forearm phalloplasty: A review of 91 cases.  ANIR-ANHP. 2004;  6 193-199
    PubMedGoogle Scholar
  • 21 Waits C A, Toby E B, Girod D A, Tsue T T. Osteocutaneous radial forearm free flap: long-term radiographic evaluation of donor site morbidity after prophylactic plating of radius.  J Reconstr Microsurg. 2007;  23 (7) 367-372
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Hu Z Q, Hyakusoku H, Gao J H, Aoki R, Ogawa R, Yan X. Penis reconstruction using three different operative methods.  Br J Plast Surg. 2005;  58 (4) 487-492
    CrossrefPubMedGoogle Scholar
  • 23 Mutaf M. Nonmicrosurgical use of the radial forearm flap for penile reconstruction.  Plast Reconstr Surg. 2001;  107 (1) 80-86
    CrossrefPubMedGoogle Scholar
  • 24 Sadove R C, McRoberts J W. Total phallic reconstruction with the free fibula osteocutaneous flap.  Plast Reconstr Surg. 1992;  89 (5) 1001
    PubMedGoogle Scholar
  • 25 Schaff J, Papadopulos N A. A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: experience in 37 patients.  Microsurgery. 2009;  29 (5) 413-419
    CrossrefPubMedGoogle Scholar
  • 26 Mutaf M, Isik D, Bulut O, Büyükgüral B. A true one-stage nonmicrosurgical technique for total phallic reconstruction.  Ann Plast Surg. 2006;  57 (1) 100-106
    CrossrefPubMedGoogle Scholar
  • 27 Rubino C, Figus A, Dessy L A et al.. Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals.  J Plast Reconstr Aesthet Surg. 2009;  62 (3) e45-e49
    CrossrefPubMedGoogle Scholar
  • 28 Lee G K, Lim A F, Bird E T. A novel single-flap technique for total penile reconstruction: the pedicled anterolateral thigh flap.  Plast Reconstr Surg. 2009;  124 (1) 163-166
    CrossrefPubMedGoogle Scholar
  • 29 Felici N, Felici A. A new phalloplasty technique: the free anterolateral thigh flap phalloplasty.  J Plast Reconstr Aesthet Surg. 2006;  59 (2) 153-157
    CrossrefPubMedGoogle Scholar
  • 30 Lin C T, Chen L W. Using a free thoracodorsal artery perforator flap for phallic reconstruction—a report of surgical technique.  J Plast Reconstr Aesthet Surg. 2009;  62 (3) 402-408
    CrossrefPubMedGoogle Scholar
  • 31 Bettocchi C, Ralph D J, Pryor J P. Pedicled pubic phalloplasty in females with gender dysphoria.  BJU Int. 2005;  95 (1) 120-124
    CrossrefPubMedGoogle Scholar
  • 32 Hu W, Lu J, Zhang L et al.. A preliminary report of penile transplantation.  Eur Urol. 2006;  50 (4) 851-853
    CrossrefPubMedGoogle Scholar
  • 33 Pestana I A, Greenfield J M, Walsh M, Donatucci C F, Erdmann D. Management of “buried” penis in adulthood: an overview.  Plast Reconstr Surg. 2009;  124 (4) 1186-1195
    CrossrefPubMedGoogle Scholar
  • 34 Ehrilch R M, Alter G J. Buried penis. In: Ehrlich R M, Alter G J, eds. Reconstructive and Plastic Surgery of the External Genitalia: Adult and Pediatric. Vol. 1. Philadelphia: Saunders; 1999: 397-401
    Google Scholar
  • 35 Alter G J. Surgical techniques: surgery to correct hidden penis.  J Sex Med. 2006;  3 (5) 939-942
    CrossrefPubMedGoogle Scholar
  • 36 Chen K L, Eberli D, Yoo J J, Atala A. Bioengineered corporal tissue for structural and functional restoration of the penis.  Proc Natl Acad Sci U S A. 2010;  107 (8) 3346-3350
    CrossrefPubMedGoogle Scholar
  • 37 Yoo J J, Park H J, Lee I, Atala A. Autologous engineered cartilage rods for penile reconstruction.  J Urol. 1999;  162 (3 Pt 2) 1119-1121
    CrossrefPubMedGoogle Scholar
  • 38 Kim B S, Yoo J J, Atala A. Engineering of human cartilage rods: potential application for penile prostheses.  J Urol. 2002;  168 (4 Pt 2) 1794-1797
    CrossrefPubMedGoogle Scholar
  • 39 Nolazco G, Kovanecz I, Vernet D et al.. Effect of muscle-derived stem cells on the restoration of corpora cavernosa smooth muscle and erectile function in the aged rat.  BJU Int. 2008;  101 (9) 1156-1164
    CrossrefPubMedGoogle Scholar
  • 40 Song Y S, Lee H J, Park I H, Kim W K, Ku J H, Kim S U. Potential differentiation of human mesenchymal stem cell transplanted in rat corpus cavernosum toward endothelial or smooth muscle cells.  Int J Impot Res. 2007;  19 (4) 378-385
    CrossrefPubMedGoogle Scholar

Christopher J SalgadoM.D. 

Miller School of Medicine, University of Miami, Holtz Children's Center – ET 3019

1611 NW 12th Avenue, Miami, FL 33136

Email: salgado_plastics@hotmail.com