Abstract
Conventional surgical techniques and emerging transplantation in complex penile reconstruction
Highlights
Despite nearly a century’s worth of cumulative experience in complex penile reconstruction, the ideal neophallus continues to elude us, presenting a significant challenge to reconstructive surgeons
We aim to review the goals of complex penile reconstruction and to discuss the various surgical options within this context
In the sections that follow, we review each of the individual donor sites commonly employed in modern, conventional phalloplasty, assessing their ability to achieve these reconstructive goals
Summary
Despite nearly a century’s worth of cumulative experience in complex penile reconstruction, the ideal neophallus continues to elude us, presenting a significant challenge to reconstructive surgeons. In 2015, the first successful penis transplant was performed in South Africa on a 21-year-old man with a penile injury sustained during cultural circumcision[9] Two years following this procedure, the recipient reported the ability to urinate and to achieve erections, orgasms, and ejaculation[53]. Most discussions on the use of penis transplantation have focused on traumatic etiologies In this context, extremity amputation or injuries may compromise reconstructive donor sites, precluding conventional options for phalloplasty. There are greater risks with penis transplantation, this may be outweighed by the improved function and aesthetics of transplanted phallus At this time, further deliberation on the use of penile transplantation in transgender men is needed as the lack of proximal corpora would preclude the ability to achieve an erection with the transplanted penis. At one year postoperatively, the most recent patient who received the most extensive penile transplantation to date reports the ability to achieve orgasm, as well as substantial improvements in pleasure scores on patient-reported outcome measures[7]
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