Phalloplasty in cis-men with penile insufficiency: evaluation of outcomes and surgical complications

Sinatti, Céline; Wolff, Dylan T.; Buncamper, Marlon E.; Verla, Wesley; Claes, Karel; Lumen, Nicolaas; Waterloos, Marjan; Monstrey, Stan; Spinoit, Anne‐Françoise

doi:10.1038/s41443-020-00385-5

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…1) [7]. However, even if techniques enhancing penile function and dimensions are applied, sometimes phalloplasty is the only possible option to offer the ability to engage in penetrative intercourse [8,9 ▪▪ ].…”

Section: Bladder Exstrophy-epispadias Complexmentioning

confidence: 99%

“…A retrospective study analyzing urinary and orgasmic outcomes of cis-males benefiting from phalloplasty in cases of severe penile insufficiency included 15 patients (50% of the total cohort) with an EEC condition [9 ▪▪ ]. Over 90% of the patients reported the ability to achieve orgasm, possibly due to the native genital tissue included in the phalloplasty.…”

Section: Bladder Exstrophy-epispadias Complexmentioning

confidence: 99%

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Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex

Sinatti

Schechter

Spinoit

2021

Current Opinion in Urology

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Purpose of review Although immediate surgical outcomes of genitourinary reconstruction used to be the main focus in hypospadias and exstrophy-epispadias complex (EEC), recent research demonstrates rising concerns about long-term functional and psychosexual outcomes. Recent results about long-term outcomes of complex genitourinary reconstruction in those children transitioning into adulthood are summarized and discussed in this comprehensive review. Recent findings Long-term outcomes in hypospadias focus on psychosexual satisfaction and decisional regret. Interestingly, uncomplicated hypospadias repair results in equal satisfaction rates to those found in controls. Most adult patients are happy with their parents’ decision to have them undergo surgery during childhood. No decisional regret was found in parents. Reinterventions were associated with a decline in satisfaction, as was a decrease in perceived penile length. Long-term, males with EEC are more dissatisfied with penile length than with continence problems. In cases of severe penile insufficiency, phalloplasty shows promising psychosexual outcomes at the price of a high complication rate. Female EEC patients show higher rates of pregnancy complications, portending a higher risk of miscarriage. Summary Psychosexual satisfaction of patients with repaired hypospadias transitioning into adulthood demonstrates equal satisfaction rates to those found in controls, without decisional regret associated with surgery during childhood. In EEC, more complications are seen when transitioning into a sexually active adult life.

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Section: Bladder Exstrophy-epispadias Complexmentioning

confidence: 99%

Section: Bladder Exstrophy-epispadias Complexmentioning

confidence: 99%

Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex

Sinatti

Schechter

Spinoit

2021

Current Opinion in Urology

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“…Over time, there have been many advances in flap techniques and neophallus designs [ 24 ]. Typically, two operative teams work simultaneously; the plastic surgery team harvests the donor site flap while the urological team prepares for and then places the flap as a neophallus [ 25 ]. Phalloplasty can be performed in a single procedure, but more commonly it is performed as staged procedures that can be done months apart [ 26 ].…”

Section: Phalloplastymentioning

confidence: 99%

“…There are various indications for phalloplasty, including penile insufficiency in cis-males and female-to-male gender reassignment surgery. In cis-males, penile insufficiency can be secondary to congenital disorders, surgical or traumatic amputation of the penis, penile fracture, and Fournier’s gangrene [ 23 , 25 , 27 ]. Relative contraindications include a body mass index of >35 kg/m 2 and truncal obesity due to added postoperative risk and increased thickness of donor sites [ 26 ].…”

Section: Phalloplastymentioning

confidence: 99%

“…Goals of phalloplasty include the creation of an aesthetically penis-like structure with sensation, the ability to have an erection, and intact micturition [ 26 ]. In cis-men, compared to trans-men, phalloplasty can incorporate native genital tissue to better improve orgasmic function [ 25 ]. The vast majority of patients prefer for the neophallus to allow for voiding while standing and thus also require the construction of a neourethra [ 23 , 28 ].…”

Section: Phalloplastymentioning

confidence: 99%

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Penile reconstruction: An up-to-date review of the literature

Ottaiano

Pincus

Tannenbaum

et al. 2021

Arab Journal of Urology

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Objective: : To review the literature on adult penile reconstruction due to Peyronie's disease, trauma and cosmesis, while emphasising specific surgical techniques and procedures such as phalloplasty, radial forearm free flap reconstruction, and penile transplant. Methods: : A comprehensive review of the literature for the years 1992-2020 of the PubMed and SpringerLink databases was performed to identify articles on penile reconstruction. Search terms included 'penile reconstruction', 'penile trauma', 'phalloplasty', 'penile transplant', and 'treatment of Peyronie's'. Relevant articles were selected. All included studies were performed on adults and written in English. Results: : We were able to identify 46 papers from PubMed and SpringerLink that included the research terms. From these, we included technical details of procedures and gleaned photographs of their works. Additionally, we included photographs from our institution's own plication surgery cases. Conclusions: : The field of adult penile reconstruction is performed for a plethora of reasons. From cosmetic to urgent and from routine to complex, it is most certainly a growing subset of Urology that plays a vital role for the men who need it. To our knowledge, this is the most up-to -date review of adult penile reconstruction.

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