Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children

Djordjević, Miroslav L.; Bumbaširević, Marko; Vuković, Petar; Sansalone, Salvatore; Perović, Sava V.

doi:10.1016/j.jpurol.2006.05.003

Cited by 72 publications

(34 citation statements)

References 10 publications

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“…[43] There are several suggestions about the timing of surgery and according to most of them phalloplasty should be performed before or at around the time of puberty. [4,33,44] Most of the techniques use somatic tissues that are not reponsive to hormones and for pediatric patients, adult-size phallus should be planned. [4,33,45] Scrotal phalloplasty described 233 Sarıkaya and Ralph.…”

Section: Discussionmentioning

confidence: 99%

Mystery and realities of phalloplasty: a systematic review

Sarıkaya

Ralph

2017

Turkish Journal of Urology

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The neophallus creation is still a mystery and it remains challenging even today. In this article, we performed a comprehensive review of the literature regarding phalloplasty and penile reconstructive surgery between January 2008 and May 2016. In this review, we have included 15 research articles and the results of 276 patients were examined. Studies revealed several indications and when indications were reviewed, 191 patients were female-to-male transgender, 9 patients had disorder of sex development/micropenis, 16 had penile amputation/trauma, 9 had ambiguus genitalia, 40 had exstrophy and/or epispadias, 11 had other problems. As a result of this review, phalloplasty is a reliable and useful operation with good functional and aesthetical results.

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Section: Discussionmentioning

confidence: 99%

Mystery and realities of phalloplasty: a systematic review

Sarıkaya

Ralph

2017

Turkish Journal of Urology

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“…Nevertheless, other types of free flaps have been described: Djordjevic et al [9] reported the musculocutaneous latissimus dorsi free flap, Sengezer et al [10] suggested the osteocutaneous free-fibula flap, and N. Felici and A. Felici [11] described the free anterolateral thigh flap. They all report satisfactory results.…”

Section: Discussionmentioning

confidence: 99%

Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

Lumen

Monstrey

Ceulemans

et al. 2008

Advances in Urology

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Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years) were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months). Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula). Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

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“…The latissimus dorsi flap has favorable characteristics for the creation of the esthetically and functionally accept able neophallus. Because of this our center has accepted this method for neophallic reconstruction, which can be seen in our published papers, for the treatment of exot rophy epispadia complex, micropenis, disorders of sexu al development, and gender incongruence [11,13]. The latissimus dorsi free flap is supplied by the thoracodorsal artery, and venous drainage is provided via thoracodor sal vein, which drains into the axillary vein.…”

Section: Medical Youth Review Articlesmentioning

confidence: 99%

“…If the created flap is smaller than 12x15 cm, in most cases there is a possibility of direct closure of the donor site without tension. How ever, in cases with bigger defects, the free Tirsch trans plant is taken from the thigh of the other leg to cover the defect [11,13]. The advantages of the latissimus dorsi free flap are the consistency of the anatomical characteristics, size of the flap and acceptable scar with direct closure of the donor region.…”

Section: Medical Youth Review Articlesmentioning

confidence: 99%

Sex reassignment surgery

Bizic¹,

Stojanovic²,

Djordjevic³

2015

Med podmladak

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SažetakTransseksualizam predstavlja stanje u kojem osoba ne oseća svojim pol u kojem je rođena i ima jaku želju da to promeni; i kao takvo je prihvaćeno u Međunarodnoj klasifikaciji bolesti. Lečenje osoba sa poremećajem pol nog identiteta zahteva multidisciplinarni pristup, u kome učestvuju psihijatri, endokrinolozi, ginekolozi, urolozi i plastični hirurzi. Hirurška rekonstrukcija genitalija pred stavlja poslednji korak u tranziciji osoba sa poremećajem polnog identiteta i može se izvesti kod onih pacijenata koji ispunjavaju uslove određene standardima Među narodnog udruženja za polnu disforiju (WPATH).Hirurške procedure u sklopu promene pola iz ženskog u muški Kod pacijenata koji menjaju pol iz ženskog u mu ški vrši se nekoliko hirurških procedura, sa ciljem da se izvedu u jednom aktu, i koje uključuju: mastektomiju, histerektomiju sa obostranom adneksektomijom, vagi nektomiju, metoidioplastiku, skrotoplastiku sa implan tacijom testis proteza i faloplastiku. Metoidioplastika obuhvata: uklanjanje vagine, oslobađanje ligamenata kli torisa i ispravljanje ventralne horde, ispravljanje i produ ženje klitorisa, rekonstrukciju uretre korišćenjem grafta bukalne mukoze i genitalnih flapova, kao i rekonstruk ciju skrotuma sa implantacijom testis proteza. U našem centru sve navedene procedure se vrše u jednom aktu, što je velika prednost za pacijenta. Rezultat je estetski odličan, omogućavajući mokrenje u stojećem stavu, kao i potpuno očuvanu seksualnu senzaciju, ali zbog malih dimenzija neofalusa penetracija nije moguća. Zbog svega navedenog, kao i zbog male stope komplikacija, pacijen ti se često opredeljuju za navedenu opciju. Oni koji hoće veći falus, koji omogućava implantaciju penilne proteze, imaju nekoliko opcija faloplastike, korišćenjem različitih režnjeva. Naš centar je razvio tehniku korišćenjem slo bodnog kožnomišićnog režnja širokog leđnog mišića, koji ima brojne prednosti u vidu veličine režnja koji omo gućava kasniju implantaciju penilne proteze, dugačke ne urovaskularne peteljke, prihvatljiv izgled donorske regije bez gubitka funkcije, kao i manji stepen kasnije retrakcije falusa. Kompletna rekonstrukcija genitalija korišćenjem navedenog režnja, uključujući i uklanjanje ženskih geni talija, kompletnu rekonstrukciju uretre, glansa i skrotuma sa testis protezama, kao i implantaciju penilne proteze, se vrši u 2 ili 3 akta i predstavlja vrlo opsežnu i kompleksnu hirurgiju sa dugim postoperativnim oporavkom.Hirurške procedure u sklopu promene pola iz muškog u ženski Kod pacijenata koji menjaju pol iz muškog u žen ski vrši se nekoliko različitih hirurških intervencija, koje sve zajedno dovode do feminizacije muškog tela (lica, grudi, vrata). U rekonstrukciji genitalija, kreiraju se vagi na, introitus vagine, ženska uretra, klitoris, velike i male usne. Metoda izbora je 'penile inversion technique' , gde se testisi uklanjaju zajedno sa kavernoznim telima penisa u potpunosti, a od ostatka muških genitalija se formiraju ženske spoljašnje genitalije: od dela glansa penisa sa ne urovaskularnom peteljkom se formira k...

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Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children

Cited by 72 publications

References 10 publications

Mystery and realities of phalloplasty: a systematic review

Mystery and realities of phalloplasty: a systematic review

Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

Sex reassignment surgery

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