title: Phallic reconstruction in cloacal exstrophy.
abstract: During the last 25 years 8 genotypic male subjects with cloacal exstrophy have undergone phallic reconstruction. All 8 patients had phallic inadequacy after completion of the reconstruction with penile lengths at or below 2 standard deviations below the mean. Of the patients 4 have reached puberty and 2 have documented physiological impotence by nocturnal penile tumescence testing. Three patients have required intensive psychiatric counseling, ranging from 18 months to 3 years because of feelings of sexual inadequacy. Of 2 patients who have attempted sexual relations 1 is unable to penetrate the vagina because of phallic size and 1 is presently engaged in successful vaginal intercourse. As a consequence of phallic inadequacy and its associated psychological trauma in these individuals we strongly recommend sexual conversion as part of the initial management plan.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas.
authors.forename: D A
authors.initials: DA
authors.lastname: Husmann
authors.forename: G A
authors.initials: GA
authors.lastname: McLorie
authors.forename: B M
authors.initials: BM
authors.lastname: Churchill
mesh_terms: D000328:Adult; D001746:Bladder Exstrophy / Q000523:psychology / Q000601:surgery*; D002648:Child; D007172:Erectile Dysfunction / Q000209:etiology; D005783:Gender Identity; D006801:Humans; D008297:Male; D010413:Penis / Q000601:surgery*; D011627:Puberty; D012731:Sex Counseling; D013518:Surgery, Plastic