Case Report
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Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report

Year 2021, Volume: 5 Issue: 12, 1224 - 1226, 01.12.2021
https://doi.org/10.28982/josam.947606

Abstract

With an increase in gender affirmation surgery requirements, it is imperative to understand the procedure for phalloplasty. The Radial Forearm Free Flap is one of the most commonly used flaps for the same. We present this case of a 29-year-old patient who underwent phalloplasty by means of a radial artery forearm free flap. Surgical technique has been described including flap design, harvest, recipient site preparation, anastomosis of vessels and nerves, and post-operative care. The patient developed a small area of partial necrosis which was the dorsoulnar border of the flap. The rest of the neophallus and neourethra were viable, sensate and the patient was able to void urine through the neourethra while standing. The radial forearm free flap is a good option for phalloplasty in gender affirmation surgeries. However, surgeons need to be wary of the possibility of necrosis of the dorsoulnar aspect which may be exceeding the radial artery territory.

Supporting Institution

M S Ramaiah Medical College Hospita

References

  • 1. Song R, Gao Y, Song Y, et al. The forearm flap. Clin Plast Surg. 1982;9:21.
  • 2. Biemer E. Penile construction by the radial arm flap. Clin Plast Surg. 1988;15:425.
  • 3. Chang T-S, Hwang WY. Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg. 1984;74:251.
  • 4. Kim S, Dennis M, Holland J, Terrell M, Loukas M, Schober J. The Anatomy of forearm free flap phalloplasty for transgender surgery. Clinical Anatomy. 2018;31:145-51
  • 5. Gottlieb LJ, Levine LA. A new design for the radial forearm free flap phallic construction. Plast Reconstr Surg. 1993;92:276.
  • 6. Lawrence A. editor. The Harry Benjamin International Gender Dysphoria Association’s Standards Of Care For Gender Identity Disorders, Sixth Version. [Internet]. World Professional Association For Transgender Health. Available from: http://wpath.org/Documents2/socv6.pdf [cited 2009 Apr16].
  • 7. Garcia MM, Christopher NA, De Luca F, Spilotros M, Ralph DJ. Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: The institute of urology, London U.K. experience. Transl Androl Urol. 2014;3:156–62.
  • 8. Song C, Wong M, Wong CH, Ong YS. Modifications of the radial forearm flap phalloplasty for female-to-male gender reassignment. J Reconstr Microsurg. 2011;27:115–20.
  • 9. Morrison SD, Shakir A, Vyas KS, Kirby J, Crane CN, Lee GK. Phalloplasty: A review of techniques and outcomes. Plast Reconstr Surg. 2016;138:594–615.
  • 10. Trombetta C, Liguori G. Management of gender dysphoria: A multidisciplinary approach. Italia: Springer. 2015; p. 249–256
Year 2021, Volume: 5 Issue: 12, 1224 - 1226, 01.12.2021
https://doi.org/10.28982/josam.947606

Abstract

References

  • 1. Song R, Gao Y, Song Y, et al. The forearm flap. Clin Plast Surg. 1982;9:21.
  • 2. Biemer E. Penile construction by the radial arm flap. Clin Plast Surg. 1988;15:425.
  • 3. Chang T-S, Hwang WY. Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg. 1984;74:251.
  • 4. Kim S, Dennis M, Holland J, Terrell M, Loukas M, Schober J. The Anatomy of forearm free flap phalloplasty for transgender surgery. Clinical Anatomy. 2018;31:145-51
  • 5. Gottlieb LJ, Levine LA. A new design for the radial forearm free flap phallic construction. Plast Reconstr Surg. 1993;92:276.
  • 6. Lawrence A. editor. The Harry Benjamin International Gender Dysphoria Association’s Standards Of Care For Gender Identity Disorders, Sixth Version. [Internet]. World Professional Association For Transgender Health. Available from: http://wpath.org/Documents2/socv6.pdf [cited 2009 Apr16].
  • 7. Garcia MM, Christopher NA, De Luca F, Spilotros M, Ralph DJ. Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: The institute of urology, London U.K. experience. Transl Androl Urol. 2014;3:156–62.
  • 8. Song C, Wong M, Wong CH, Ong YS. Modifications of the radial forearm flap phalloplasty for female-to-male gender reassignment. J Reconstr Microsurg. 2011;27:115–20.
  • 9. Morrison SD, Shakir A, Vyas KS, Kirby J, Crane CN, Lee GK. Phalloplasty: A review of techniques and outcomes. Plast Reconstr Surg. 2016;138:594–615.
  • 10. Trombetta C, Liguori G. Management of gender dysphoria: A multidisciplinary approach. Italia: Springer. 2015; p. 249–256
There are 10 citations in total.

Details

Primary Language English
Subjects Surgery, Urology
Journal Section Case report
Authors

George Taliat 0000-0002-9152-8358

Kumaraswamy Mohan Kumar This is me 0000-0003-3039-9350

Arjun Nagaraj This is me 0000-0002-5573-0065

Publication Date December 1, 2021
Published in Issue Year 2021 Volume: 5 Issue: 12

Cite

APA Taliat, G., Mohan Kumar, K., & Nagaraj, A. (2021). Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report. Journal of Surgery and Medicine, 5(12), 1224-1226. https://doi.org/10.28982/josam.947606
AMA Taliat G, Mohan Kumar K, Nagaraj A. Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report. J Surg Med. December 2021;5(12):1224-1226. doi:10.28982/josam.947606
Chicago Taliat, George, Kumaraswamy Mohan Kumar, and Arjun Nagaraj. “Phalloplasty – Sensate Radial Forearm Free Flap for Creation of Neourethra and Neophallus in Gender Affirmation Surgery: A Case Report”. Journal of Surgery and Medicine 5, no. 12 (December 2021): 1224-26. https://doi.org/10.28982/josam.947606.
EndNote Taliat G, Mohan Kumar K, Nagaraj A (December 1, 2021) Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report. Journal of Surgery and Medicine 5 12 1224–1226.
IEEE G. Taliat, K. Mohan Kumar, and A. Nagaraj, “Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report”, J Surg Med, vol. 5, no. 12, pp. 1224–1226, 2021, doi: 10.28982/josam.947606.
ISNAD Taliat, George et al. “Phalloplasty – Sensate Radial Forearm Free Flap for Creation of Neourethra and Neophallus in Gender Affirmation Surgery: A Case Report”. Journal of Surgery and Medicine 5/12 (December 2021), 1224-1226. https://doi.org/10.28982/josam.947606.
JAMA Taliat G, Mohan Kumar K, Nagaraj A. Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report. J Surg Med. 2021;5:1224–1226.
MLA Taliat, George et al. “Phalloplasty – Sensate Radial Forearm Free Flap for Creation of Neourethra and Neophallus in Gender Affirmation Surgery: A Case Report”. Journal of Surgery and Medicine, vol. 5, no. 12, 2021, pp. 1224-6, doi:10.28982/josam.947606.
Vancouver Taliat G, Mohan Kumar K, Nagaraj A. Phalloplasty – Sensate radial forearm free flap for creation of neourethra and neophallus in gender affirmation surgery: A case report. J Surg Med. 2021;5(12):1224-6.