title: Neophalloplasty in boys with aphallia: A systematic review.
abstract: OBJECTIVE
  Aphallia is a rare penile congenital abnormality. The aim of this systematic review was to assess all available literature on neophalloplasty in infancy with an interest in technical alternatives and clinical outcome.
  
  
  METHODS
  We performed a Pubmed search using the terms: neophalloplasty, neophallus, and phalloplasty, and selected articles that presented technical alternatives for penile construction in cases of penile dysgenesis, especially aphallia in children and/or adolescents.
  
  
  RESULTS
  A total of 319 articles were identified in the initial search. Among the different techniques presented in 19 papers collected, we categorized reconstructive procedures into two groups: microsurgical and non-microsurgical techniques. Among the microsurgical techniques, procedures such as the osteocutaneous fibular flap (n = 18), the myocutaneous latissimus dorsi flap (n = 24), and the radial forearm free flap (n = 293) were reported. Among the non-microsurgical techniques, we found a wider range of technical options (6 in total). Most were based on groin, abdominal, and scrotal flaps. Long-term reports on the functionability of the neophallus and psychological aspects of the patients are lacking.
  
  
  CONCLUSIONS
  In assessing recent literature, it seems rational that neophalloplasty should be regarded as the preferred strategy for boys born with aphallia, in opposition to female gender assignment.
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil. Electronic address: degoliveira@gmail.com.
authors.forename: Diego Estevam Gomes
authors.initials: DE
authors.lastname: Oliveira
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Marcela Leal
authors.initials: ML
authors.lastname: da Cruz
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Riberto
authors.initials: R
authors.lastname: Liguori
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Gilmar
authors.initials: G
authors.lastname: Garrone
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Leslie
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Sérgio Leite
authors.initials: SL
authors.lastname: Ottoni
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Geórgia Rubiane
authors.initials: GR
authors.lastname: Souza
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Valdemar
authors.initials: V
authors.lastname: Ortiz
authors.affiliation: Pediatric Surgery, Hospital CdC Petrucciani, Lecce, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: de Castro
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: Macedo
mesh_terms: D002648:Child; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000151:congenital / Q000601:surgery*; D010413:Penis / Q000002:abnormalities* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Aphallia; Neophalloplasty; Pediatric; Penis