title: Urethral reconstruction in patients suffering from aphallia: a reconstructive challenge.
abstract: OBJECTIVE
  To document our experience (at a tertiary health care center) of reconstruction of the urethra in 3 male patients suffering from aphallia and congenital urethrorectal fistula as well as their long-term follow-up.
  
  
  METHODS
  Extensive single-stage urethroplasty in 3 patients suffering from aphallia was performed. Prior to that, neophallus reconstruction was done in all 3 patients after puberty. In a single stage, we used oral mucosa and pedicled penile skin onlay for anterior urethra reconstruction and groin-based pedicle (Singapore) flap for posterior urethra substitution surgery. The current follow-up is between 2 and 5 years. During the last follow-up, the patients also answered questions from a validated patient-reported outcome measure and quality of life questionnaire.
  
  
  RESULTS
  All the 3 patients are voiding well in the standing position with a mean Q(max) of 14 ml/s. None of them has any problems related to the neourethra as per their last follow-up. All 3 patients were satisfied with the surgical procedures related to the aphallia correction and stated that the surgery did not interfere with the quality of their lives.
  
  
  CONCLUSIONS
  Reconstruction of the urethra from pedicled skin flap combined with buccal mucosa graft urethroplasty gives durable and satisfactory long-term results.
authors.affiliation: Department of Urology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
authors.forename: Mahendra
authors.initials: M
authors.lastname: Bhandari
authors.forename: Rahul Janak
authors.initials: RJ
authors.lastname: Sinha
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D005832:Genital Diseases, Male / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007194:India; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D017060:Patient Satisfaction; D010413:Penis / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012003:Rectal Fistula / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D014548:Urinary Fistula / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects; D055815:Young Adult