Pre-fabricated radial forearm phalloplasty with cadaveric bone graft

Abstract

Phalloplasty is a complex set of procedures used in efforts to improve the anatomical, physiological, and aesthetic deficiencies caused by loss or absence of the penis. Methods have evolved significantly, and the use of free tissue transfer has become common amongst reconstructive surgeons. The inclusion of bone autograft, usually radius or fibula, within the neophallus has caused significant morbidity, and efforts continue to find the optimal solution. We present a novel approach using a pre-fabricated, radial forearm fasciocutaneous free flap containing cadaveric bone graft for phalloplasty following traumatic penis amputation.

Keywords: Phalloplasty; Pre-fabrication; Cadaver allograft; Radial forearm; Penile reconstruction

Core tip: While there are many options for penile reconstruction, many techniques have associated morbidity when attempting to recreate rigidity in the neophallus by using bone autograft mostly from either the radius or fibula. In our case report, we use a novel approach to addressing rigidity in the neophallus without causing associated morbidity by using a pre-fabricated, radial forearm fasciocutaneous free flap containing cadaveric bone graft for reconstructive phalloplasty.