A salvage procedure for redo penile prosthesis implantation in phalloplasty (De castro technique) for congenital aphallia

Abstract

Introduction: We present a different salvage procedure for penile prosthesis implantation in a De Castro neophallus.

Methods: A patient with congenital aphallia had been operated at the age of 11. Ten years later he had two non successful attempts of prosthesis implantation. Surgery consisted of adapting the implants into the aortic graft and folding it in the middle over the cylinders to reinforce its strength.

Results: Patient had a successful postoperative course and has now 6 months of follow-up.

Discussion: In a systematic review of penile prosthetic outcomes and complications in gender-affirming surgery, most of the prostheses were inflatable (83.6%) and single-cylinder (61.0%). At a mean follow-up of 3.0 years: 36.2% of prosthesis complications, 60.0% of patients had their original implant present and 83.9% reported achieving penetration. We decided to use vascular grafts as a scaffold because of former non successful attempts.

Conclusion: The use of vascular prosthesis as a device to implant the penile prosthesis seems to be a safe and effective alternative in an attempt to offer erectile function to the neophallus in case of congenital aphallia.

Keywords: Congenital aphallia; Neophalloplasty; Penile prosthesis.