PD29-10 RETROSPECTIVE ANALYSIS OF PHALLOPLASTY BY A SPECIALIZED TRANSGENDER SURGERY CENTER

Abstract

You have accessJournal of UrologyCME1 May 2022PD29-10 RETROSPECTIVE ANALYSIS OF PHALLOPLASTY BY A SPECIALIZED TRANSGENDER SURGERY CENTER Brenna Briles, Jessica Gondran, Emma R. Linder, Michael Safir, Curtis Crane, and Richard Santucci Brenna BrilesBrenna Briles More articles by this author , Jessica GondranJessica Gondran More articles by this author , Emma R. LinderEmma R. Linder More articles by this author , Michael SafirMichael Safir More articles by this author , Curtis CraneCurtis Crane More articles by this author , and Richard SantucciRichard Santucci More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002577.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Phalloplasty is a masculinizing genital gender affirmation surgery, requested by 91% of patients seeking surgical transition. Due to the complexity of reconstruction involved, phalloplasty has been associated with high complications, with all cause urinary complications being reported as high as 70%1. The objective of our study is to observe the specific urinary, emergent, donor site, and aesthetic complications associated with this complex procedure. METHODS: Data was gathered via retrospective chart review of 280 transmasculine patients undergoing phalloplasty at our center between 7/17 and 10/20 (38 months). RESULTS: Patients had an average follow up period of 17 months. Average age at phalloplasty was 34 years (range 18-64). 66% (185/280) received a radial forearm flap, 34% (94/280) received anterolateral thigh flap, and 0.4% (1/280) received a musculocutaneous latissimus dorsi flap. The average phallus length was 5.7 inches (range 4.5-8.5). Patients with prior masculinizing genital gender affirming surgery included: 23 metoidioplasty, 3 phalloplasty, and 28 vaginectomy. Thirty patients (11%) experienced a complication requiring urgent surgery or emergency room admission, and 19 patients (7%) experienced complications of the donor site requiring surgery. Many patients experienced urinary tract complications (Table 1) while 21 patients (7.5%) did not have urethral lengthening. No patients experienced rectal injury. Total phallus loss occurred in two cases (0.7%), due to vascular insufficiency and subsequent necrosis. Eighteen patients experienced infection of the phallus, which were resolved with antibiotics or minor incision/drainage. Seven patients (2.5%) had no phallic sensation. There were a variety of procedures done for aesthetic and hygienic purposes post-phalloplasty (Table 1). Overall, patients experienced an average of 3.6 complications requiring surgery (range 0-18) and had an average of 2.8, usually planned, visits to the operating room after phalloplasty (range 0-12). CONCLUSIONS: This is the first report of phalloplasty results from a US, high-volume (∼90 cases year), dedicated phalloplasty unit. This detailed analysis of complications of this hypercomplex surgery should prove useful to practitioners, patients and payors alike. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e508 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brenna Briles More articles by this author Jessica Gondran More articles by this author Emma R. Linder More articles by this author Michael Safir More articles by this author Curtis Crane More articles by this author Richard Santucci More articles by this author Expand All Advertisement PDF DownloadLoading ...