Penile reconstruction

Abstract

During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.

Figure 1

Glansectomy followed by reconstruction with the use of urethral flaps. (a) The glans penis is excised and the entire penile urethra is dissected off the corpora cavernosa in order to gain enough length to be spatulated on the top of the denuded corpora to form a pseudoglans. (b) The final result. The spatulated urethral flap is bent backward to feature the pseudoglans.

Figure 2

Simultaneous corporeal reconstruction and penile prosthesis implantation in patients with penile inadequacy and severe corporeal fibrosis and contracture following repeated explantation of infected penile prosthesis. (a) The corpora are contracted and diffusely fibrotic. (b) A midline longitudinal incision of the penile skin is performed and the corpora exposed. Two longitudinal paraurethral corporeal incisions are carried out and the fibrotic tissue excised. (c) The corpora are reconstructed with the use of two longitudinal grafts. (d) The cylinders of a three pieces inflatable penile prosthesis are inserted in the reconstructed corpora cavernosa.