(520) The Use of Gracilis Muscle Flap in Radial Forearm Free Flap Phalloplasty to Decrease Urethral Fistula Rate: Initial Outcome

Abstract Introduction `- Chang and Hwang, in 1984, described the technique of Radial Forearm Free Flap Phalloplasty (RFFFP). It is now considered to be standard surgery for phallic reconstruction. Urethral fistula most common complication reported RFFFP may reach up 60-70%. Most commonly, site at anastomosis between native urethra neo-urethra. Objective study impact gracilis muscle flap wrapping around urethra/neo-urethral on decreasing rate. Methods A prospective was conducted our urology department, from January 2018 till December 2020. - Patients presenting with a micropenis (Stretched penile length <7 cm) underwent wrapping. The free-flap harvested non-dominant forearm. Under microscopic guidance, radial artery anastomosed inferior epigastric artery, cephalic vein great saphenous vein, medial lateral antecubital nerves ilio-inguinal dorsal respectively. pedicled then wrapped neo-urethera/native urethral assess its possible role postoperative urinary Results Nineteen patients were included median age 26 years (16 43) BMI 24 (22-25). hospital stay 14 days (14 21) follow-up 11 months (4 13). cold ischemia time 90 mins (70 100), estimated blood loss 500 cc (400 500) operative hrs (10 12). viable phallus achieved 13 (overall free survival 68.4%). Of successfully cases, 8 cases (42.1%) complicated by complete disruption remaining five (26.3%) had tube. One case them developed anastomosis, one distal ring stricture anastomosis. prevented formation 4 out 5 (80%) Conclusions use garcilis neo-urethra/native during RFFP might helpful reducing fistulae rates this site. However, larger comparative studies are needed. Disclosure No