Reconstructive Surgery for Severe Penile Injury: One-Stage Penile Reconstruction (Phalloplasty) Using Pedicled Island Anterolateral Thigh Flap

Aim: To evaluate the functional and aesthetic results of one-stage penile reconstruction (phalloplasty) using an island anterolateral thigh flap Patients and methods: Twelve male patients (age 16 to 43 years) were treated with a penile reconstruction admitted to plastic & reconstructive surgery unit of Bahawal Victoria Hospital Bahawalpur and Sheikh Zayed Hospital, Rahim Yar Khan from November 2008 to June 2011. All patients presented with post-traumatic total or subtotal amputation of the penis. In all the patients an island anterolateral thigh flap (ALTF) was used for penile reconstruction. Mean follow-up was 16 months. The ALTF is an alternative when a free flap is contraindicated or not desired by the patient. Results: Complete necrosis of the flap was not recorded. Partial necrosis of the distal end of the flap was found in two cases which healed completely with conservative measures. Aesthetic results were judged as good in 8 patients and moderate in 3 patients. Five patients developed urinary complications (fistula). Protective and tactile sensitivity was satisfactory in all patients. In 8 patients rib bone graft was used as penile stiffener and they were well satisfied with the regular sexual performance. Conclusion: The pedicled island anterolateral thigh flap (ALTF) is a very good option for nonmicrosurgical one-stage penile reconstruction.