title: [The pedicled anterolateral thigh flap for penile reconstruction].
abstract: OBJECTIVE
  To introduce the application of pedicled anterolateral thigh (ALT) flap for total penile reconstruction and to investigate its feasibility and effect.
  
  
  METHODS
  From May 2011 to May 2015, 12 male patients presented with absence of the penis or congenital malformation received phalloplasty with the pedicled ALT flap. Of them, the median age was 35 years old (range, 20-57 years). The size of the flaps ranged from 11 cm x 11 cm to 12 cm x 15 cm. 8 patients underwent urethra reconstruction with tube-in-tube flaps and other 4 patients with scrotal septal flaps. In this series, we performed one-stage urethral anastomosis in 4 cases and second-stage urethral anastomosis 6 months after the phalloplasty in 8 cases.
  
  
  RESULTS
  An acceptable reconstructed phallus was achieved in 10 patients. These flaps were primarily healed with satisfactory functional and cosmetic results. The reconstructed penis was completely necrosis because of the flap failure in one case. The distal half of the phallus was lost due to infection in one case. Both of them were treated with pedicled ALT flap from the other side. Reliable results were achieved. At a median follow-up of 1.5 year (range 1 to 4 years), 9 patients (90%) were fully satisfied with phallic cosmesis and size, and 4 patients who was married had successful sexual intercourse. 8 patients had normal urinate function. Fistula was developed in 2 patients (20%) which was treated with delayed repair at 6-12 months with local scrotal flaps.
  
  
  CONCLUSIONS
  The pedicled ALT flap can be simply used to reconstruct an entire penis as well as a urethra. It has several advantages including a less conspicuous donor site, greater bulk, better color match and no necessary for microsurgery.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhe
authors.forename: Li
authors.initials: L
authors.lastname: Yangqun
authors.forename: Tang
authors.initials: T
authors.lastname: Yong
authors.forename: Zhao
authors.initials: Z
authors.lastname: Muxin
authors.forename: Chen
authors.initials: C
authors.lastname: Wen
authors.forename: Ma
authors.initials: M
authors.lastname: Ning
authors.forename: Wang
authors.initials: W
authors.lastname: Weixin
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D003075:Coitus; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D010413:Penis / Q000002:abnormalities / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012611:Scrotum; D013524:Surgical Flaps / Q000473:pathology / Q000637:transplantation*; D013848:Thigh; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D055815:Young Adult