Total penile reconstruction: A systematic review

A. Yao, M. J. Ingargiola, C. D. Lopez, P. Sanati-Mehrizy, N. M. Burish, E. M. Jablonka, P. J. Taub

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


Background: Phalloplasty poses a unique challenge to the plastic and reconstructive surgeon. The development of advanced microsurgical techniques has greatly augmented the range of surgical approaches available. Methods: A systematic review of the MEDLINE and Cochrane databases was performed to identify clinical studies of total penile reconstruction published within the last 10 years using the search algorithm: “(phallus or penis or penile) and (reconstruction or phalloplasty or transplant)”. Results: The primary literature search retrieved 1400 articles. After applying inclusion and exclusion criteria, 30 studies were selected for review. The radial forearm free flap is the preferred technique for total phalloplasty; however, other techniques including the fibular osteocutaneous flap, anterolateral thigh flap, latissimus dorsi flap, scapular free flap, and abdominal flap are described. Background, indications, and preoperative and postoperative care are also discussed. Conclusions: Total penile reconstruction can provide functional, aesthetic, and psychosocial benefits to the patient. Use of the radial forearm free flap has been proposed as the gold standard; however, the wide range of potential complications associated with phalloplasty warrants an individualized approach to each patient.

Original languageEnglish
Pages (from-to)788-806
Number of pages19
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number6
StatePublished - Jun 2018


  • Gender affirmation surgery
  • Gender dysphoria
  • Penile surgery
  • Phalloplasty
  • Surgical flaps
  • Total penile reconstruction


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