Abstract
The radial forearm flap is an established procedure for phalloplasty. 3 different methods concerning flap design and urethral construction are reported in the literature. A literature review between the years 1993 and 2012 was performed. The purpose of the review was an analysis of the different techniques of the radial forearm flap with respect to urethral construction in forming a phallus in female to male transsexual patients. Urological and flap specific complications were assed and compared between the methods. 9 studies with 714 patients were included into the analysis. One stage procedures for phalloplasty were performed in the majority of cases in 665 patients (93%). Among these 530 patients (74.2%) received a Chang design phallic construction. A 2 stage procedure with a prelaminated urethra was conducted in 49 patients (7%) and reported in 3 studies. The results show a higher rate of urological complications for the technique with urethra prefabrication so far. However, this technique presents with a lower incidence of partial flap loss and smaller donor sites compared to the Chang design phalloplasty. No conclusions can be drawn for the Gottlieb design penile construction because only few and incomplete data are available in the literature.
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