Total phalloplasty using a musculocutaneous latissimus dorsi flap

• DOI: 10.1111/j.1464-410x.2007.07084.x
• Publication Date: 2007-09-07T11:06:58Z
• Authors: Sava V. Perovic; Rados Djinovic; Marko Bumbasirevic; Miroslav Djordjevic; Petar Vukovic
• Keywords: Phalloplasty; Neurovascular bundle; Cephalic vein

To present total phalloplasty in children and adults using a musculocutaneous latissimus dorsi (MLD) free flap to create large neophallus, that allows easy urethroplasty implantation of prosthesis.From April 1999 January 2006, 16 patients (mean age 24 years, range 10-34) had phalloplasty; the indications were congenital anomalies penis 12, iatrogenic two accidental penile trauma two. The MLD is mobilized on subscapular artery vein, thoracodorsal nerve. neophallus created on-site after dividing neurovascular pedicle, transferred pubic region, where it anastomosed with femoral artery, saphenous vein ilio-inguinal donor site was closed directly 15 while one split-thickness skin graft used cover defect. In following stages, two- or three-stage buccal mucosa 11 patients; prosthesis implanted seven.The mean (range) follow-up 31 (12-74) months; 14-18 cm long 11-15 circumference. There no partial necrosis; healed satisfactorily 13 remaining three there moderate scarring. patency urethra good all patients. Two urethrocutaneous fistulae developed; spontaneously other successfully treated minor surgery. function prostheses satisfactory patients.The creation size aesthetic appearance; safe prosthesis, can also be children.