Номер №4, 2018 - page 100-103

Urethroplasty of neophallus with radial forearm flap with prefabrication of urethra by buccal graft (clinical case)

Sokol'schik M.M., Kyzlasov P.S., Bokov A.I., Kolpacinidi F.G.
Information about authors:
  • Sokolshchik M.M. – Dr. Sc., Professor of the Department of Urology and Andrology of the Institute of Inorganic Chemistry A. I. Burnazyan of the FMBA of Russia; Moscow; e-mail: 7203331@gmail.com
  • Kyzlasov P.S. – Dr. Sc., associate professor of the Department of Urology and Andrology of the Institute of Inorganic Chemistry A. I. Burnazyan FMBA of Russia, Moscow; e-mail: dr.kyzlasov@mail.ru
  • Bokov A.I. – assistant of the Department of Urology and Andrology of the Institute of Inorganic Chemistry A. I. Burnazyan FMBA of Russia, Moscow; e-mail: dr.Bokov@bk.ru
  • Kolpatsini F.G. – assistant of the Department of Urology and Andrology IOPS A. I. Burnazyan FMBA of Russia, Moscow; e-mail: Fedor_dr@mail.ru
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Complications of urethral reconstruction in patients with neo-phallus remain one of the main problems in urology. The unsatisfactory results both in the longest and the longest postoperative period, such as strictures and fistulas of the neo-urethra, a decrease in the elasticity of the neurater, the growth of hair in the lumen of the formed urethra, and as a consequence, incrustation leading to the formation of neo-urethral stones. Autotubes are used to replace extended defects of the urethra (traumatic, iatrogenic) or long urethral strictures: local displaced and rotated skin flaps, free mucous membranes and skin autografts, but these techniques are not applicable to the formation of neo-phallus due to a deficiency of local tissues and the peculiarities of the blood supply to the neo-phallus. To date, the neovascular method for neo-phallic patients is a revascularized autograft. The main drawback of plastics is a sharp decrease in the possibility of anatomical and functional restoration of the tissue structures of the urogenital area. To reduce the number of complications and improve immediate and long-term results, we developed a new method of urethral plasty, consisting of pre-replacement of the dermis of the forearm of the mucosa of the cheek, followed by the formation of the urethra by a cutaneous radial tubularized flap on microsurgical anastomoses. A description of the clinical case, methodology and results is provided. Good plastic and functional results of plasty of the neo-phallic urethra have been obtained, which leads to social and sexual adaptation. This technique can be used both for the simultaneous plasty of the urethra and for the stepwise reconstructive-plastic intervention.

Authors declare lack of the possible conflicts of interests.

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urethroplasty, phalloplasty, neophallus, buccal flap, congenital diseases, traumatic amputation of the penis, extensive stricture of the urethra

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