Skip to content

Genital Surgery Belgrade - GenitalSurgeryBelgrade.com

Increase font size Decrease font size Default font size

News Flash

IMPORTANT NOTICE! Dr Miroslav Djordjevic will not be present on the International Foundation for Gender Education Conference, Washington, DC,USA,due to no fly zone over Europe which is caused by volcanic ash in the atmosphere.
You are here:  Home Phalloplasty
Skip to content
Phalloplasty

Phalloplasty is surgical procedure of creating a neophallus from an extra genital tissue that provides male-like and functional penis.

Major indications for phalloplasty can be divided in two groups: male patients with penile insufficiency, and female to male transgender patients. Penile insufficiency can be caused by congenital anomalies (penile agenesia, micropenis, failed epispadia and hyposapdia repair or disorders of sex development) and acquired conditions such as iatrogenic or accidental injuries.
For some of these patient phalloplasty can be performed even in pediatric age in order to prevent profound psychological problems related to body dysmorphia. In female to male gender reassignment surgery phalloplasty presents a major surgical step.

Ideal phalloplasty must gratify both cosmetic and functional requirements. Created neophallus should have aspect of normal male penis, with acceptable scarring of donor site. Voiding must be feasible in standing position. Neophallus have to be huge enough to enable inserting of penile prosthesis which can obtain satisfactory rigidity and hence provide penetration during sexual intercourse.

There are many alternatives for extragenital tissue tht can be used for creation of neophallus (groin flap, forearm flap, rectus abdominis flap, fibular flap, musculocutaneous latissimus dorsi flap). The musculocutaneous latissimus dorsi flap is an acceptable choice for phalloplasty in all these groups of patients because it has a reliable and suitable vascular anatomy, large surface area, giving an excellent penile size, large enough to allow creation of the urethra and implantation of a penile prosthesis. Moreover, the penis can be constructed to the size desired by the patient. The donor site can be closed directly in most patients, with a satisfactory outcome if it is prepared appropriately by superficial skin massage using anti-scar ointment to improve skin elasticity. Hidden donor site is additonal advange in comparison to other more exposed donor sites.  The latissimus dorsi total phalloplasty can entirely meet the esthetic and functional requirements of penile reconstruction.

Case 1 Total phalloplasty
(click image for larger view)

001.jpg
Design of the latissimus dorsi muscle flap.
001.jpg
Flap harvesting.
001.jpg
Tubularization of the flap.
001.jpg
Donor site closure. Direct approximation with split ticknes skin graft.
001.jpg
Appearance after surgery.


Case 2 Total phalloplasty - Second stage
(click image for larger view)

001.jpg
Appearance after first stage total phalloplasty.
001.jpg
Dilatation of the phallus for penile prosthesis insertion. Flap harvesting.
001.jpg
Semirigid penile prosthesis implantation. (dorsal approach)
001.jpg
Closure of the phallic base.
001.jpg
Reconstruction of distal urethra: buccal mucosa graft stage I.
001.jpg
Glans reconstruction.


Case 3 Total phalloplasty with metoidioplasty
(click image for larger view)

001.jpg
Appearance before FTM SRS.
001.jpg
Genital flaps for urethral lengthening.
001.jpg
Genital flaps for urethral lengthening.
001.jpg
Perineal reconstruction. Scrotoplasty with silicone testicle implants.
001.jpg
Design of the latissimus dorsi muscle flap.
001.jpg
Direct closure of donor site.
001.jpg
Microvascular anastomosis of the flap blood supply and recipient blood vessels.
001.jpg
Appearance after complete surgery.
001.jpg
Appearance two weeks later: phallus has survived.



feed0 Comments

Write comment
 
 
quote
bold
italicize
underline
strike
url
image
quote
quote
smaller | bigger
 

security image
Write the displayed characters


busy