Phalloplasty: a valuable treatment for males with penile insufficiency.
OBJECTIVE
To apply a phalloplasty technique used in female-to-male transsexual surgery in male patients with penile insufficiency.


METHODS
Seven male patients (aged 15 to 42 years) were treated with phalloplasty (6 with radial forearm free flap and one with anterolateral thigh flap) between March 2004 and April 2006 (follow-up, 9 to 34 months). All patients suffered psychologically from their condition, with low self-esteem and sexual and relational dysfunction. They were evaluated by a sexologist-psychiatrist before and after surgery. Erectile implant surgery is offered approximately 1 year after the phallic reconstruction.


RESULTS
There were no complications concerning the flap. Two complications were reported in the early postoperative period. Two patients developed urinary complications (stricture and/or fistula). Patient satisfaction after surgery was high in 6 cases and moderate in 1 case. Psychological evaluation confirms this, especially on the self-esteem level. Four patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed.


CONCLUSIONS
This success has convinced us that phalloplasty is a valuable treatment for penile insufficiency. It has good results in terms of patient self-esteem and sexual well-being. This technique opens new horizons for the treatment of penile agenesis, micropenis, crippled penis, shrivelled penis, some disorders of sexual development, traumatic amputations, and cloacal exstrophy.
Lumen
Nicolaas
N
Department of Urology, Ghent University Hospital, Ghent, Belgium. lumennicolaas@hotmail.com
Monstrey
Stanislas
S
Selvaggi
Gennaro
G
Ceulemans
Peter
P
De Cuypere
Griet
G
Van Laecke
Eric
E
Hoebeke
Piet
P
D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D015917:Penile Prosthesis; D010413:Penis / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D014189:Transsexualism / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods