(037) Contemporary Surgical and Functional Outcomes of Anterolateral Thigh Flap for Penile Reconstruction

Abstract Introduction The radial forearm free flap phalloplasty is the most commonly used for penile reconstruction. anterolateral thigh (ALT) was proposed in 2006 as an alternative due to twin advantages of a more easily hidden scar and improved flexibility length flap. A pedicled variant ALT same year thus offering greater security vascular supply suitable patients. Previous reports have highlighted higher rates loss low integrated urethra. Objective aim study report contemporary surgical outcomes phalloplasty. In addition, functional are reported first time. Methods All patients undergoing were included between 2009 2021. Data extracted from comprehensive prospective database medical records. Functional assessed by non-validated questionnaire. Results Seventy-six underwent with mean follow-up 34 months (SEM ± 3.05). Median age 32 (IQR 26 – 46) body mass index 24 0.61). significant minority had previous (22%). 7% other co-morbidities including diabetes peripheral disease. Over half all flaps (n=41) designed urethra 6.6% (n=5) required transfer. average stay seven days ±0.47). Post-surgery, five (6.6%) experienced total loss, further three (3.9%) experiencing partial loss. Urethral complications common eleven (26.8%) developing fistulae (7.3%) strictures. Fifty-three (69%) completed Forty-three (81%) generally satisfied their phalloplasty, while thirty-four (65%) felt they good cosmetic outcome. Twenty-eight (53%) sensation at least phallus. Eight (17%) troublesome post-micturition dribbling. Conclusions Presented one largest cohort following genital gender affirmation surgery using successfully (gold standard urethral reconstruction). (an important determinant choice flap) time showing 81% despite challenging almost quarter salvage failed Disclosure No