Pedicled Anterolateral Thigh and Radial Forearm Free Flap Phalloplasty for Penile Reconstruction in Patients With Bladder Exstrophy
Research article published in The Journal of urology (2020)
Abstract
PURPOSE: Male patients with exstrophy-epispadias complex have a congenitally short penis. Adolescent and adult patients often desire penile reconstruction to enable penetrative intercourse. When penile lengthening using local tissue and/or skin graft is unsuitable, phalloplasty is performed. We provide updated experiences using radial forearm free flap and pedicled anterolateral thigh flap phalloplasty techniques over a 6-year period in exstrophy-epispadias complex patients. MATERIALS AND METHODS: Consecutive patients who underwent radial forearm free flap or pedicled anterolateral thigh flap phalloplasty between 2013 and 2019 were reviewed. A total of 11 patients were identified, including 8 with classic bladder exstrophy and 3 with cloacal exstrophy. In each case, flap dimensions, donor and recipient vessels and nerves, complications, outcomes and subsequent surgical procedures are reported. RESULTS: A radial forearm free flap was performed in 6 patients and a pedicled anterolateral thigh flap in 5. Flap survival was observed in all cases and 5 patients subsequently received an inflatable penile prosthesis. Among patients undergoing a pedicled anterolateral thigh flap, there was 1 mortality from acute pulmonary embolism, and the other 4 required at least 1 debulking procedure. CONCLUSIONS: Phalloplasty is an important procedure in patients with exstrophy-epispadias complex with severe penile inadequacy. Both techniques have favorable long-term outcomes, although the pedicled anterolateral thigh flap frequently requires a later debulking procedure. The radial forearm free flap is preferred but if the radial forearm is overly thin and the risk of inflatable penile prosthesis extrusion is high, the pedicled anterolateral thigh flap is an acceptable alternative.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Male patients with exstrophy-epispadias complex have a congenitally short penis.
Por qué esto importa para la hirudoterapia
Este artículo reporta una experiencia quirúrgica de 6 años con faloplastia mediante colgajo pediculado anterolateral de muslo y colgajo libre radial de antebrazo en 11 pacientes con complejo extrofia-epispadias vesical, documentando la supervivencia de los colgajos en todos los casos, una mortalidad por embolia pulmonar y la necesidad frecuente de adelgazamiento tras la reconstrucción con colgajo anterolateral de muslo. El estudio se centra en las técnicas y los resultados de cirugía urológica reconstructiva. No se menciona ningún tipo de sanguijuelas, hirudoterapia, anticoagulantes derivados de sanguijuela ni ninguna intervención relacionada. Si bien la cirugía de colgajo libre es un ámbito en el que las sanguijuelas medicinales se utilizan en ocasiones en otros contextos para rescatar colgajos con congestión venosa, este estudio concreto no empleó terapia con sanguijuelas, y ninguna de las complicaciones o resultados descritos involucró intervenciones relacionadas con sanguijuelas. Por lo tanto, la relevancia para el ámbito de ASH es inexistente, sin ninguna conexión defendible con sanguijuelas.
Citación
Pedicled Anterolateral Thigh and Radial Forearm Free Flap Phalloplasty for Penile Reconstruction in Patients With Bladder Exstrophy
Harris TGW et al. · The Journal of urology, 2020
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026