title: Second free radial forearm flap for urethral reconstruction after partial flap necrosis of tube-in-tube phalloplasty with radial forearm flap: a report of two cases.
abstract: We present a salvage procedure to reconstruct the neo-urethra after partial flap necrosis occurring in free radial forearm flap (RFF) phalloplasty for sex reassignment surgery. Two cases of tube-in-tube phalloplasty using a free sensate RFF are described in which partial flap necrosis occurred involving the complete length of the neo-urethra and a strip of the outer lining of the neo-phallus. Neo-urethra-reconstruction was performed with a second RFF from the contralateral side providing well-vascularized tissue. No flap-related complications were observed. Twelve months postoperatively, both patients were able to void while standing. A satisfactory aesthetic appearance of the neo-phallus could be preserved with an excellent tactile and erogenous sensitivity. Using this technique, we successfully salvaged the neo-urethra and reconstructed the outer lining of the neo-phallus
authors.affiliation: Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland.
authors.forename: Laurent A H
authors.initials: LA
authors.lastname: Tchang
authors.forename: René D
authors.initials: RD
authors.lastname: Largo
authors.forename: Doris
authors.initials: D
authors.lastname: Babst
authors.forename: Reto
authors.initials: R
authors.lastname: Wettstein
authors.forename: Martin D
authors.initials: MD
authors.lastname: Haug
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kalbermatten
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000473:pathology; D006801:Humans; D008297:Male; D009336:Necrosis; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D057830:Gender-Affirming Surgery / Q000379:methods*; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods