(183) Radial Artery Free Flap Urethroplasty

Abstract

Abstract Introduction Urethroplasty is an essential component of gender-affirming phalloplasty for transgender individuals who desire the ability to stand to void through a neophallus. Objective We demonstrate the creation of a neourethra using a radial artery free flap for transmasculine individuals with an existing neophallus using live surgical footage. Methods The patient was a 36 year old transmasculine individual who had undergone abdominal phalloplasty 6 months prior, and desired the ability to stand to void. Two teams may simultaneously work; one will harvest a radial forearm flap from the non-dominant upper extremity following a preoperative Allen's test. The flap is tubularized over a catheter. The other team will open the existing neophallus and groin site to prepare the flap recipient site. Following microvascular anastomosis, a micro-Doppler is used to confirm perfusion. The donor site is covered with a skin graft and negative pressure wound dressing. Results The patient had an uneventful recovery after 48 hours of bedrest with head of bed maintained at 30 degrees, and scheduled flap checks. They were discharged on postoperative day 5 after removal of the negative pressure forearm dressing. He has recovered well and has satisfactory orthotopic voiding on follow-up visits. Conclusions This technique of radial artery flap urethroplasty is a safe and effective option for patients who desire a neourethra with their neophallus. Disclosure No.