Problem solving after phalloplasty with toraco-dorsal autograft using rotated inguinal flap

Adamyan R.T., Istranov A.L., Vasil'eva E.E., Kuchba N.D.

Nowadays, the problem of еру restoration of external male genitalia in case of their loss, inherent absence and development alterations is very actual. The main aim of surgical treatment in these situations is creation of aesthetically proper and sexually functional phallus with incorporated neo-urethra, capable for micturition. Many surgical techniques were proposed until recently. One of the best well-grounded techniques is microsurgical phalloplasty with free re-vascularized re-innervated toracodorsal autograft (TDAG). Nevertheless, this technique is not devoid of post-operative complications, i.e. vascular failure of the graft. In the course of this complication the partial necrosis of the tissues could be seen. Emergency decompression of the vascular pedicle of the graft in case of the edema could lead to the major skin defects and to the loss of the tubular form of the neophallus.

In this article we suggest the surgical decision for this complication using rotated inguinal flaps. This method was utilized in 8 patients with vascular failure of the graft. It made possible to fully cover all lacerations and to rehabilitate the patients.

In this article we present a clinical case, showing efficacy of the mentioned surgical method.

Drawing a conclusion, vascular complications of the TDAG phalloplasty could be successfully managed using the rotated inguinal flaps.

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