Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals

An update on penile reconstruction

“…[25][26][27][28][29][30][31] In particular, osteocutaneous flaps have been designed in order to guarantee the rigidity necessary to achieve successful penetrative intercourse; the main disadvantages of these flaps are that the phallus is difficult to conceal and the bone component tends to be progressively desorbed with consequent loss of rigidity. 32 In miocutaneous flaps instead, muscle contracture is common and this leads to poor cosmetic results.…”

Penile reconstruction/formation

“…[29,37,38 ,39 ,46-51,52 ,53 ] Urinary tract problems Kim et al [38 ] Multistaged Leriche et al [39 ] Stiffener/permanent erection if bone is used Donor-site morbidity Anterolateral thigh flap Felici and Felici [43] No long-term follow-up present Rubino et al [44] Possibly similar limits to radial forearm flap Fibula flap…”

“…(1) pedicled anterolateral thigh flap [43] (six cases performed), (2) innervated island pedicled anterolateral thigh flap for neophallic reconstruction in female-to-male transsexuals [44] (one case), (3) free prefabricated fibular flap without fibula [42] (five cases), (4) reinnervated latissimus dorsi myocutaneous free flap [45 ] (22 cases), with a minimum follow-up of 11 months: their complication rate was high (seven hematomas, two vascular thrombosis, one partial necrosis, three excessive swelling of the neophallus, one skin graft loss at donor site).…”

An Unusual Case of Neurogenic Sexual Dysfunction Due to Lead Exposure

“…Anatomy of the cavernous nerves are mixed autonomic nerves that is responsible for penile erection, ejaculation and detumescence [11]. The pudendal nerve plays an essential role in pudendal evoked potentials, last phases of penile erection, threshold of somatosensory reflexes and ejaculation [12]. Decreased libido is secondary to altered hypothalamic-pituitary axis and altered orgasm [13].…”