Total phallic reconstruction using radial artery free flap

Abstract

The evolution of phallic reconstruction parallels the advances in reconstructive surgery. The procedure has gone through various changes from random tube skin flaps to island skin and/ or musculocutaneous flaps, to the modern microsurgical free tissue transfers that now form the state of art technique in phallic reconstruction. The loss of phallus in case of trauma, whether accidental, felonious or self - inflicted has a devastating psychological consequence that persists in a victims life. An optimally reconstructed phallus should provide tactile and erogenous sensibility, neourethra allowing voiding while standing, capability of successful vaginal intromission with insertion of prosthesis, cosmetically acceptable neophallus, cosmetically acceptable flap donor site and capability to grow with age in paediatric patients. Though modern reconstructive and microsurgical procedures permit us to achieve most of these aims but a single stage reconstruction still eludes us.