title: Advances in total phalloplasty and urethroplasty with microvascular free flaps.
abstract: This article focuses on the lateral arm free flap as the option that comes closest to meeting the diverse aesthetic and functional goals of phalloplasty. The authors introduce a new technique for incorporating a prefabricated neourethra within the lateral arm to permit the coexistence of an erectile prosthesis alongside a fully vascularized urethra that extends to the distal tip. The unrecognized value of the radial forearm free flap for urethroplasty is also discussed and a case of reconstruction following urethral loss is presented. Also described is how the prefabricated urethra technique may be useful for repairing severe hypospadias defects.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: V L
authors.initials: VL
authors.lastname: Young
authors.forename: R K
authors.initials: RK
authors.lastname: Khouri
authors.forename: G W
authors.initials: GW
authors.lastname: Lee
authors.forename: J A
authors.initials: JA
authors.lastname: Nemecek
mesh_terms: D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010413:Penis / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*; D014521:Urethra / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*