(04) Infrapubic Phalloplasty

Park, S.H.

Phalloplasty, Penile Length, Penile Girth, Xenograft

This video describes the surgical technique and results of infrapubic phalloplasty with xenograft (fetal bovine dermis) in Korean patients. This advantageous approach allows enhanced access to the fundiform and suspensory ligaments. Designed to minimize vascular disruption of the penile skin, the technique maximizes cosmetic benefit by minimizing the incision and providing a natural postoperative appearance. The incision is made similar to an infrapubic penile implant. The outpatient one hour procedure is performed with local anesthesia described as a penile root block. The patient is to void prior to surgery and no catheter is used. The xenograft is hydrated in room temperature normal saline for at least 20 minutes prior to use. Careful dissection around the superficial dorsal vein complex and partial dissection of the suspensory ligament is performed. The penile shaft is retracted outward by dissection of the dartos fascia. The dartos and Buck’s fascia are further dissected to reveal the contour of the corona of the glans. A 5 point fixation is then described just below the glans with absorbable suture. Proper closing techniques, postoperative instructions/restrictions, and antibiotic regimen are discussed. The authors relay their results at the conclusion of the surgical video. 1502 Korean men underwent infrapubic phalloplasty at their institution between 2010-2014. 1497 of these men had retrospective review of their results with at least 3 months follow up. Mean preoperative girth and length were 8.146 cm +/- 1.031 and 8.644 cm+/- 1.741 respectively. Immediate post operative length was reported with increased girth to 11.03cm +/-0.989 and increased length to 12.02 +/- 1.909 cm length. Postoperative measurements after 3 months were increased girth to 11.00 cm+/- 1.168 and increased length to 11.61 cm+/- 1.790. According to the authors, this represents a 49.39% gain in girth and 34.9% gain in length.