Phallic Construction and Penile Reconstruction

Abstract

The term phallus originates from the Greek word meaning “penis-like,” or “primordial penis.” Thus, any manmade creation of a “penis” is correctly, by definition, a phallus. The reproductive function, combined with the need for a urethra, makes penile reconstruction and phallic construction challenging. Ideally, each should be done in a single stage that is reliably reproducible. The phallus or reconstructed penis should have both tactile and erogenous sensibility created or maintained. The organ must be created with a competent neourethra that will allow voiding while standing. In most patients, there are concerns about subsequent capacity for insertion of a prosthetic stiffener to allow for successful intercourse. The phallus must be aesthetically acceptable to both patient and partner, and in the case of prepubertal phallic construction the phallus must grow so that it will have an acceptable adult size. Modern tissue transfer and reconstructive surgical and microsurgical techniques allow achievement of these objectives; however, they have yet to be achieved in a single-stage procedure.