30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles
Background:. The technique of urogenital plastic surgery continues to pose difficulties for surgeons due to physical features of the anatomical region, which complicates the correction of various severe male urogenital pathologies. The goal of the surgeon is to create a neophallus that allows for ur...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-04-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004963 |
| _version_ | 1827939512051826688 |
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| author | Ruben T. Adamyan, MD, PhD, DSci Olesya I. Startseva, MD, PhD, DSci Mark A. Gabriyanchik, MD |
| author_facet | Ruben T. Adamyan, MD, PhD, DSci Olesya I. Startseva, MD, PhD, DSci Mark A. Gabriyanchik, MD |
| author_sort | Ruben T. Adamyan, MD, PhD, DSci |
| collection | DOAJ |
| description | Background:. The technique of urogenital plastic surgery continues to pose difficulties for surgeons due to physical features of the anatomical region, which complicates the correction of various severe male urogenital pathologies. The goal of the surgeon is to create a neophallus that allows for urination and intercourse with minimal damage to the donor site. This special topic provides a historical overview and principles for optimal phalloplasty. To improve results in latissimus dorsi free-flap phalloplasty, we share our approach, its benefits, and the lessons we have learned.
Methods:. We performed a retrospective review of patients who underwent shaft-only, two-stage or one-stage latissimus dorsi flap phalloplasty with or without reinnervation at a single institution from 1991 through 2020. Patients with a minimum of 1 year of follow-up were included. Data on the patient’s demographics, the procedure, and the results of the operation were maintained.
Results:. In total, 592 latissimus dorsi flap phalloplasties were performed during the entire study period. Of the phalloplasties, 494 (83.5%) were performed for gender-affirming surgery, of which 470 were performed for transgender patients and 24 for intersex patients. Twenty-five patients (4.2%) had congenital malformations, 17 (2.9%) had oncologic resections, and 56 had posttraumatic loss (9.5%).
Conclusion:. Latissimus dorsi flap total phalloplasty with reinnervation is currently one of the few methods that can solve not only an aesthetic problem, but also a functional one without the use of an endoprosthesis if the level of reinnervation and muscle contraction is sufficient. |
| first_indexed | 2024-03-13T08:55:43Z |
| format | Article |
| id | doaj.art-ba49eca45e894f8795f9586c5af5bdee |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-13T08:55:43Z |
| publishDate | 2023-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-ba49eca45e894f8795f9586c5af5bdee2023-05-29T03:33:02ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-04-01114e496310.1097/GOX.0000000000004963202304000-0005630 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal PrinciplesRuben T. Adamyan, MD, PhD, DSci0Olesya I. Startseva, MD, PhD, DSci1Mark A. Gabriyanchik, MD2From the * Department of Plastic Surgery, Yerevan State Medical University, Yerevan, Armenia† Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russian Federation.† Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russian Federation.Background:. The technique of urogenital plastic surgery continues to pose difficulties for surgeons due to physical features of the anatomical region, which complicates the correction of various severe male urogenital pathologies. The goal of the surgeon is to create a neophallus that allows for urination and intercourse with minimal damage to the donor site. This special topic provides a historical overview and principles for optimal phalloplasty. To improve results in latissimus dorsi free-flap phalloplasty, we share our approach, its benefits, and the lessons we have learned. Methods:. We performed a retrospective review of patients who underwent shaft-only, two-stage or one-stage latissimus dorsi flap phalloplasty with or without reinnervation at a single institution from 1991 through 2020. Patients with a minimum of 1 year of follow-up were included. Data on the patient’s demographics, the procedure, and the results of the operation were maintained. Results:. In total, 592 latissimus dorsi flap phalloplasties were performed during the entire study period. Of the phalloplasties, 494 (83.5%) were performed for gender-affirming surgery, of which 470 were performed for transgender patients and 24 for intersex patients. Twenty-five patients (4.2%) had congenital malformations, 17 (2.9%) had oncologic resections, and 56 had posttraumatic loss (9.5%). Conclusion:. Latissimus dorsi flap total phalloplasty with reinnervation is currently one of the few methods that can solve not only an aesthetic problem, but also a functional one without the use of an endoprosthesis if the level of reinnervation and muscle contraction is sufficient.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004963 |
| spellingShingle | Ruben T. Adamyan, MD, PhD, DSci Olesya I. Startseva, MD, PhD, DSci Mark A. Gabriyanchik, MD 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles Plastic and Reconstructive Surgery, Global Open |
| title | 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles |
| title_full | 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles |
| title_fullStr | 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles |
| title_full_unstemmed | 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles |
| title_short | 30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles |
| title_sort | 30 years of experience in musculocutaneous latissimus dorsi flap phalloplasty with reinnervation optimal principles |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004963 |
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