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Obtaining Rigidity in Total Phalloplasty: Experience With 35 Patients

2003; Lippincott Williams & Wilkins; Volume: 169; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(05)64072-4

1527-3792

Piet Hoebeke, Greta De Cuypere, Peter Ceulemans, Stan Monstrey,

Pain Management and Treatment

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2003Obtaining Rigidity in Total Phalloplasty: Experience With 35 Patients P. HOEBEKE, G. De CUYPERE, P. CEULEMANS, and S. MONSTREY P. HOEBEKEP. HOEBEKE , G. De CUYPEREG. De CUYPERE , P. CEULEMANSP. CEULEMANS , and S. MONSTREYS. MONSTREY View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64072-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The combination of a neourethra and erection prosthesis in a single neophallus in the female-to-male transsexual remains a challenge. The outcome reported in the literature is disappointing. We report our experience with 35 patients. Materials and Methods: Between August 1996 and December 2001, 35 patients underwent implantation surgery. A 1-piece hydraulic Dynaflex prosthesis (American Medical Systems, Minnetonka, Minnesota) was used in 10 patients, while a 3-piece hydraulic CXM and CX (American Medical Systems) prosthesis was placed in 9 and 16, respectively. The 1-piece model was withdrawn from the market in 1997. Thereafter a 3-piece prosthesis was implanted. Results: Of 10 patients in the 1-piece group prosthesis implantation was uneventful in 8. In 2 patients with technical failure the prosthesis was replaced, including 1 in whom the new prosthesis was removed due to infection and successfully replaced by a 3-piece prosthesis. To date at a mean followup of 3.5 years 9 patients have a 1-piece hydraulic prosthesis in place. In the 3-piece prosthesis group of 25 patients implantation was uneventful in 20. In 1 patient infection and partial necrosis of the neophallus developed, 2 had infection, in 1 a cylinder perforated the tip of the phallus and in 1 technical failure occurred. Of the latter 4 patients the prosthesis was replaced successfully in 2 patients, while the other 2 are on the waiting list. The patient with partial necrosis of the phallus is no longer a candidate for an erection prosthesis. To date at a mean followup of 1.8 years 23 patients have a 3-piece hydraulic prosthesis in place. A single patient in the 1-piece group has a 3-piece CX prosthesis. Conclusions: Good results were observed after implantation of the Dynaflex prosthesis in patients who underwent total phalloplasty. This model is no longer available today. For the more complex 3-piece CX and CXM prostheses implantation results are comparable to those of the 1-piece model. References 1 : Phalloplasty in female-to-male transsexuals: what do patients ask for?. Ann Plast Surg1993; 30: 323. Google Scholar 2 : Obtaining rigidity in the neophallus of female-to-male transsexuals: a review of the literature. Ann Plast Surg1993; 30: 327. Google Scholar 3 : Penile prosthesis implantation in total phalloplasty. J Urol1994; 152: 410. Link, Google Scholar 4 : Transsexual surgery in the genetic female. Clin Plast Surg1988; 15: 471. Google Scholar 5 : Results of phalloplasty. Plast Reconstr Surg1979; 64: 163. Google Scholar 6 : Dynaflex prosthesis in total phalloplasty. Plast Reconstr Surg1999; 99: 479. Google Scholar 7 : Surgical therapy in transsexual patients: a multi-disciplinary approach. Acta Chir Belg2001; 101: 200. Google Scholar 8 : Construction of male genitalia in the transsexual, using a tubed groin flap for the penis and a hydraulic inflation device. Plast Reconstr Surg1978; 61: 523. Google Scholar 9 : Prosthesis placement after total phallic reconstruction. J Urol1993; 149: 593. Link, Google Scholar 10 : Phalloplasty in female-to-male transsexuals: what do our patients ask for?. Ann Plast Surg1993; 30: 323. Google Scholar From the Departments of Pediatric Urology and Urogenital Reconstruction, Plastic Surgery and Psychiatry, Ghent University Hospital, Gent, Belgium© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 169Issue 1January 2003Page: 221-223 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordspenile implantationpenisprostheses and implantstranssexualismprosthesis implantationMetricsAuthor Information P. HOEBEKE More articles by this author G. De CUYPERE More articles by this author P. CEULEMANS More articles by this author S. MONSTREY More articles by this author Expand All Advertisement PDF downloadLoading ...