Phalloplasty for an amputated phallus in intersex patients

OBJECTIVE To report our experience of phalloplasty using a radial forearm free-flap (RFF) and insertion of a penile prosthesis for the amputated phallus. PATIENTS AND METHODS Phalloplasty was carried out in nine intersex patients with ambiguous genitalia as a result of female circumcision, with a consequent partial or complete excision of their microphallus. Six months later a penile prosthesis was inserted in the periostium of the lower border of the symphysis pubis in the first six patients. RESULTS All patients were fully satisfied with the size and cosmetic appearance of their penis. One patient had a urinary fistula that was closed surgically. All of the patients are continent. The penile prosthesis was implanted successfully with no complications. CONCLUSIONS Phalloplasty using a RFF and insertion of a penile prosthesis for the amputated phallus are technically feasible, with good clinical and functional outcomes.