Total Urethra and Penile Shaft Reconstruction with Combined Pedicled Anterolateral Thigh Flap and Radial Forearm Free Flap after Total Penectomy

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License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_8165E80B0791
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Total Urethra and Penile Shaft Reconstruction with Combined Pedicled Anterolateral Thigh Flap and Radial Forearm Free Flap after Total Penectomy
Journal
Archives of Plastic Surgery
Author(s)
di Summa Pietro Giovanni, Sapino Gianluca, Bauquis Olivier
ISSN
2234-6163
2234-6171
Publication state
Published
Issued date
05/2022
Volume
49
Number
03
Pages
448-452
Language
english
Abstract
Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation. The indication for a double flap phalloplasty was posed as only way to fully reconstruct the urethra on its length avoiding possible complications of single flap reconstruction using tube-into-tube technique. Both flaps healed uneventfully with no neourethral strictures or fistulas described. At 18 months follow-up, the patient was extremely satisfied with the aesthetic result and was able to void in standing position. We think that a double free tissue transfer for TPR should be considered, particularly when a urethral length > 14 cm needs to be reconstructed. While the pedicled ALT can be used to reconstruct a proper penile shaft with an easily concealed scar, the RFFF can provide adequate neourethra length with satisfactory sensory recovery at the neoglans.
Keywords
penile reconstructionurethra reconstructionALT perforator flapdouble flap
Web of science
Open Access
Yes
Create date
10/06/2022 16:15
Last modification date
23/11/2022 8:12
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