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Second free radial forearm flap for urethral reconstruction after partial flap necrosis of tube‐in‐tube phalloplasty with radial forearm flap: A report of two cases
Authors:Laurent AH Tchang MD  René D Largo MD  Doris Babst MD  Reto Wettstein MD  Martin D Haug MD  Daniel F Kalbermatten MD  PhD  Dirk J Schaefer MD
Institution:Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, , Basel, Switzerland
Abstract:We present a salvage procedure to reconstruct the neo‐urethra after partial flap necrosis occurring in free radial forearm flap (RFF) phalloplasty for sex reassignment surgery. Two cases of tube‐in‐tube phalloplasty using a free sensate RFF are described in which partial flap necrosis occurred involving the complete length of the neo‐urethra and a strip of the outer lining of the neo‐phallus. Neo‐urethra‐reconstruction was performed with a second RFF from the contralateral side providing well‐vascularized tissue. No flap‐related complications were observed. Twelve months postoperatively, both patients were able to void while standing. A satisfactory aesthetic appearance of the neo‐phallus could be preserved with an excellent tactile and erogenous sensitivity. Using this technique, we successfully salvaged the neo‐urethra and reconstructed the outer lining of the neo‐phallus © 2013 Wiley Periodicals, Inc. Microsurgery 34:58–63, 2013.
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