Faloplastia mediante colgajo libre microquirúrgio antebraquial radial con doble tunelización. A propósito de un caso

Abstract

Reconstruction of penile defects remains one of the greatest challenges in Plastic Surgery because of the inherent complexity of restoring both the anatomical form and the urologic function of the penis. The surgeon's ideal goals in performing a phalloplasty include the construction, in one-stage procedure, of an aesthetic penis with erogenous and tactile sensation, which enables the patient to void while standing and to have sexual intercourse. The multitude of flaps used for phalloplasty only demonstrates that none of these techniques is considered ideal. Still, the radial forearm flap is the most frequently used one and universally considered as the standard technique. The relative disadvantages of this technique are the rather high number of initial fistulas, the residual scar on the forearm, and the potential long-term urologic complications. We describe a penile reconstruction using a radial forearm free flap with a new two-dimensional geometric design that allows the creation of a three-dimensional neophallus with an excellent aesthetic result.