Penile Stiffener in Phalloplasty

Kwon, Tae Gyun; Cbung, Sung Kwang; Park, Yeon Kyu

Abstract

Total phallic reconstruction may be necessary in various conditions such as traumatic or surgical loss of the penis, congenital penile absence, micropenis, pseudohermaphroditism and transsexualism In spite of recent advances in free tissue transfers and microneurovascular techniques, which have improved the results of total penile reconstruction, this operation still remains one of the greatest challenges in genitourinary surgery. And the simulation of erection remains most difficult goal to achieve especially in patients with congenital micropenis or female-to-male transsexuals. We have performed penile reconstruction in 6 patients since 1989, utilizing radial forearm osteocutaneous flap. The most common complication is related to neourethra and the most difficult problem is to obtain satisfactory penile rigidity, especially in patients with congenital micropenis. We conclude that there is a need for specially designed stiffeners which is specifically tailored to the abnormal perineal anatomy of these patients, as well as additional surgical improvement in urethral reconstruction.