Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound
Summary:. In phalloplasty, the radial forearm free flap is the most commonly used flap, followed by the anterolateral thigh flap. Superficial circumflex iliac artery perforator (SCIP) flaps have been used in phalloplasty, but bulkiness and unstable perfusion have precluded their common use. In this...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-09-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005280 |
| _version_ | 1797671791548694528 |
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| author | Hidehiko Yoshimatsu, MD Ryo Karakawa, MD Yuma Fuse, MD Tomoyuki Yano, MD |
| author_facet | Hidehiko Yoshimatsu, MD Ryo Karakawa, MD Yuma Fuse, MD Tomoyuki Yano, MD |
| author_sort | Hidehiko Yoshimatsu, MD |
| collection | DOAJ |
| description | Summary:. In phalloplasty, the radial forearm free flap is the most commonly used flap, followed by the anterolateral thigh flap. Superficial circumflex iliac artery perforator (SCIP) flaps have been used in phalloplasty, but bulkiness and unstable perfusion have precluded their common use. In this report, we present a case in which tube-in-tube phalloplasty was performed using bilateral SCIP flaps assisted by preoperative high-resolution ultrasonography. A 67-year-old man underwent resection of his penis for treatment of carcinoma. A year later, phalloplasty using bilateral SCIP flaps was planned. After mapping out the superficial circumflex iliac artery and the superficial circumflex iliac vein to their terminal portions using preoperative high-resolution ultrasonography, a 12 cm × 8 cm rectangular flap was designed on the right groin for reconstruction of the phallus, and a 10 cm × 4 cm rectangular flap was designed on the left groin for reconstruction of the urethra. Both flaps were harvested above the superficial fascia, and the thickness of both flaps was 4 mm. The Foley catheter was removed three weeks after the operation, and the patient began urinating in the standing position. No fistula or urethral stenosis had occurred as of 12 months after the reconstruction, and the patient was satisfied with the cosmesis. The use of preoperative high-resolution ultrasonography played a decisive role in ensuring the perfusion of the flap, resulting in prevention of postoperative complications such as fistula and/or urethral stenosis caused by malperfusion of the flap. |
| first_indexed | 2024-03-11T21:20:41Z |
| format | Article |
| id | doaj.art-32aa507c4c454705b06fed5f14f6a04e |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-11T21:20:41Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-32aa507c4c454705b06fed5f14f6a04e2023-09-28T07:09:03ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-09-01119e528010.1097/GOX.0000000000005280202309000-00047Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution UltrasoundHidehiko Yoshimatsu, MD0Ryo Karakawa, MD1Yuma Fuse, MD2Tomoyuki Yano, MD3From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.Summary:. In phalloplasty, the radial forearm free flap is the most commonly used flap, followed by the anterolateral thigh flap. Superficial circumflex iliac artery perforator (SCIP) flaps have been used in phalloplasty, but bulkiness and unstable perfusion have precluded their common use. In this report, we present a case in which tube-in-tube phalloplasty was performed using bilateral SCIP flaps assisted by preoperative high-resolution ultrasonography. A 67-year-old man underwent resection of his penis for treatment of carcinoma. A year later, phalloplasty using bilateral SCIP flaps was planned. After mapping out the superficial circumflex iliac artery and the superficial circumflex iliac vein to their terminal portions using preoperative high-resolution ultrasonography, a 12 cm × 8 cm rectangular flap was designed on the right groin for reconstruction of the phallus, and a 10 cm × 4 cm rectangular flap was designed on the left groin for reconstruction of the urethra. Both flaps were harvested above the superficial fascia, and the thickness of both flaps was 4 mm. The Foley catheter was removed three weeks after the operation, and the patient began urinating in the standing position. No fistula or urethral stenosis had occurred as of 12 months after the reconstruction, and the patient was satisfied with the cosmesis. The use of preoperative high-resolution ultrasonography played a decisive role in ensuring the perfusion of the flap, resulting in prevention of postoperative complications such as fistula and/or urethral stenosis caused by malperfusion of the flap.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005280 |
| spellingShingle | Hidehiko Yoshimatsu, MD Ryo Karakawa, MD Yuma Fuse, MD Tomoyuki Yano, MD Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound Plastic and Reconstructive Surgery, Global Open |
| title | Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound |
| title_full | Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound |
| title_fullStr | Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound |
| title_full_unstemmed | Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound |
| title_short | Tube-in-Tube Phalloplasty with Tailor-made Bilateral Superficial Circumflex Iliac Artery Perforator Flaps Using Preoperative High-resolution Ultrasound |
| title_sort | tube in tube phalloplasty with tailor made bilateral superficial circumflex iliac artery perforator flaps using preoperative high resolution ultrasound |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005280 |
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