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Functional and surgical outcomes after phalloplasty in cis men

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A Letter to the Editor to this article was published on 30 October 2023

Abstract

Purpose

Evaluate the surgical outcomes along with a comprehensive assessment of functional outcomes in cis men (non-trans) who underwent phalloplasty.

Methods

All consecutive cis men who underwent phalloplasty from 2008 to 2018 for penile insufficiency due to various causes were included. These underwent phalloplasty by either a radial forearm free flap (RFFF) or suprapubic phalloplasty (SPP). Data were collected from medical files. A questionnaire was sent a minimum of 1 year after surgery to each patient to evaluate sexual function and self-esteem, satisfaction with genitals, and urinary function.

Results

Among the 19 patients included, 12 underwent RFFF and 7 SPP; 25% of those who had RFF and 14.3% of those with SPP had a Clavien–Dindo ≥ 2 complication. A total of 16 patients had a urethroplasty procedure, 50.0% of whom had a Clavien–Dindo ≥ 2 complication. Penile prostheses were implanted in 14 patients; 64.3% of whom had a complication. Seven patients answered the questionnaire (36.8%); the relationship satisfaction score was 89.5/100 and the confidence score was 100/100. Among the 5 patients who had a sexual relationship, all reported having a lot of pleasure during sexual intercourse and reached orgasm at least “regularly”. At least 66.7% of the patients were “satisfied” or “very satisfied” about the size and the appearance of genitals. Among the 5 patients who answered questions regarding urinary function, 60.0% had standing micturition, and 80.0% reported being comfortable in public toilets.

Conclusion

Despite the high frequency of complications and the need for revision surgery, phalloplasty seems to allow a satisfying psychosexual and urinary functions for cis men suffering from penile insufficiency.

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Funding

This study was funded by Association Française d’Urologie.

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Authors and Affiliations

  1. Department of Urology, Hospices Civils de Lyon, Hôpital Lyon Sud, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite Cedex, France

    Agate Escoffier, Nicolas Morel-Journel, Manon Terrier, Léna Paganelli, Alain Ruffion, Damien Carnicelli & Paul Neuville

  2. Lyon Sud Medical School, Claude Bernard University Lyon 1, Pierre-Bénite, France

    Alain Ruffion & Paul Neuville

  3. Department of Plastic and Reconstructive Surgery, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France

    Fabien Boucher

Authors
  1. Agate Escoffier
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  2. Nicolas Morel-Journel
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  3. Manon Terrier
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  4. Léna Paganelli
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  5. Fabien Boucher
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  6. Alain Ruffion
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  7. Damien Carnicelli
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  8. Paul Neuville
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Contributions

AE: data collection or management, data analysis, and manuscript writing/editing. NM: project development and data collection or management. MT: data collection or management. LP: data collection or management. FB: project development and data collection or management. AR: project development. DC: project development and data collection or management. PN: project development, data collection or management, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Paul Neuville.

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Escoffier, A., Morel-Journel, N., Terrier, M. et al. Functional and surgical outcomes after phalloplasty in cis men. World J Urol 40, 2635–2640 (2022). https://doi.org/10.1007/s00345-022-04141-w

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  • DOI: https://doi.org/10.1007/s00345-022-04141-w

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