Complex Reconstructive Corporoplasty

Abstract

Congenital and especially recurrent complex pathologies of the corpora cavernosa need an integrated surgical approach (urological and plastic surgery). The fields of application of these techniques are: a) correction of congenital pathologies of the male genitalia; b) genital reconstruction after radical pelvic surgery; c) genital reconstruction after trauma. An adequate experience in surgery of flaps, the knowledge of their vascularisation and biology, the observance of particular intraoperative procedures and an accurate postoperative management are mandatory. This is also the case of surgery in female to male transsexuals. Different techniques have been proposed but few of them give aesthetically and functionally satisfactory results. In our experience clitoridal enlargement and urethral transfer, in anatomically selected patients and after substitutive hormonal therapy, give sufficient guarrantee of conservation of sensitivity and erectile capacity and have a positive psychological impact on the patient. When cosmetic dimensional emphasis is required as regards the neophalius the transfer of a rectal abdominal muscle flap with epidermal graft has given, in our experience, satisfactory results.