Penile Prostheses in Transgender Males

  • Krishna S. Vyas
  • Shane D. Morrison
  • Richard A. Santucci


Penile prostheses can be placed after phalloplasty in transmen to allow for rigidity. Protective sensation is generally thought of as one of the requirements prior to insertion of penile prosthesis. Complications can be substantial. In this chapter we discuss technical considerations for prosthetic placement and management of complications.


Penile prosthetic Phalloplasty Transgender Complications 


  1. 1.
    Ascha M, Massie JP, Morrison SD, Crane CN, Chen ML. Outcomes of single stage phalloplasty by pedicled anterolateral thigh flap versus radial forearm free flap in gender confirming surgery. J Urol. 2018;199(1):206–14. Epub 2017/08/03. PubMed PMID: 28765066CrossRefGoogle Scholar
  2. 2.
    Massie JP, Morrison SD, Wilson SC, Crane CN, Chen ML. Phalloplasty with urethral lengthening: addition of a vascularized bulbospongiosus flap from vaginectomy reduces postoperative urethral complications. Plast Reconstr Surg. 2017;140(4):551e–8e. Epub 2017/09/28. PubMed PMID: 28953722CrossRefGoogle Scholar
  3. 3.
    Morrison SD, Chen ML, Crane CN. An overview of female-to-male gender-confirming surgery. Nat Rev Urol. 2017;14(8):486–500. Epub 2017/05/17. PubMed PMID: 28508877CrossRefGoogle Scholar
  4. 4.
    Morrison SD, Shakir A, Vyas KS, Kirby J, Crane CN, Lee GK. Phalloplasty: a review of techniques and outcomes. Plast Reconstr Surg. 2016;138(3):594–615. Epub 2016/08/25. PubMed PMID: 27556603CrossRefGoogle Scholar
  5. 5.
    Remington AC, Morrison SD, Massie JP, Crowe CS, Shakir A, Wilson SC, Vyas KS, Lee GK, Friedrich JB. Outcomes after phalloplasty: do transgender patients and multiple urethral procedures carry a higher rate of complication? Plast Reconstr Surg. 2018;141(2):220e–9e. Epub 2017/10/12. PubMed PMID: 29019859
  6. 6.
    Hoebeke P, de Cuypere G, Ceulemans P, Monstrey S. Obtaining rigidity in total phalloplasty: experience with 35 patients. J Urol. 2003;169(1):221–3. Epub 2002/12/13. PubMed PMID: 12478140
  7. 7.
    Hage JJ, Bloem JJ, Bouman FG. Obtaining rigidity in the neophallus of female-to-male transsexuals: a review of the literature. Ann Plast Surg 1993;30(4):327–333. Epub 1993/04/01. PubMed PMID: 8512288CrossRefGoogle Scholar
  8. 8.
    Morrison SD, Massie JP, Dellon AL. Genital sensibility in the neophallus: getting a sense of the current literature and techniques. J Reconstr Microsurg. 2018. Epub 2018/08/06;35:129–37. PubMed PMID: 30078177CrossRefGoogle Scholar
  9. 9.
    Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, Trost L, Morey AF. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med. 2016;13(4):489–518. Epub 2016/04/06. PubMed PMID: 27045255CrossRefGoogle Scholar
  10. 10.
    De Castro R, Merlini E, Rigamonti W, Macedo A Jr. Phalloplasty and urethroplasty in children with penile agenesis: preliminary report. J Urol. 2007;177(3):1112–6; discussion 7. Epub 2007/02/14. PubMed PMID: 17296424CrossRefGoogle Scholar
  11. 11.
    Chang TS, Hwang WY. Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg. 1984;74(2):251–8. Epub 1984/08/01. PubMed PMID: 6463150CrossRefGoogle Scholar
  12. 12.
    Ranno R, Vesely J, Hyza P, Stupka I, Justan I, Dvorak Z, Monni N, Novak P, Ranno S. Neo-phalloplasty with re-innervated latissimus dorsi free flap: a functional study of a novel technique. Acta Chir Plast. 2007;49(1):3–7. Epub 2007/05/02. PubMed PMID: 17469438Google Scholar
  13. 13.
    Falcone M, Garaffa G, Gillo A, Dente D, Christopher AN, Ralph DJ. Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery. BJU Int. 2018;121(1):139–44. Epub 2017/09/25. PubMed PMID: 28940910CrossRefGoogle Scholar
  14. 14.
    Hoebeke PB, Decaestecker K, Beysens M, Opdenakker Y, Lumen N, Monstrey SM. Erectile implants in female-to-male transsexuals: our experience in 129 patients. Eur Urol. 2010;57(2):334–40. Epub 2009/03/24. PubMed PMID: 19303200CrossRefGoogle Scholar
  15. 15.
    Neuville P, Morel-Journel N, Maucourt-Boulch D, Ruffion A, Paparel P, Terrier JE. Surgical outcomes of erectile implants after phalloplasty: retrospective analysis of 95 procedures. J Sex Med. 2016;13(11):1758–64. Epub 2016/10/25. PubMed PMID: 27693264CrossRefGoogle Scholar
  16. 16.
    Zuckerman JM, Smentkowski K, Gilbert D, Storme O, Jordan G, Virasoro R, Tonkin J, McCammon K. Penile prosthesis implantation in patients with a history of total phallic construction. J Sex Med. 2015;12(12):2485–91. Epub 2015/12/10. PubMed PMID: 26645889CrossRefGoogle Scholar
  17. 17.
    Henry GD, Kansal NS, Callaway M, Grigsby T, Henderson J, Noble J, Palmer T, Cleves MA, Ludlow JK, Simmons CJ, Mook TM. Centers of excellence concept and penile prostheses: an outcome analysis. J Urol. 2009;181(3):1264–8. Epub 2009/01/21. PubMed PMID: 19152945CrossRefGoogle Scholar
  18. 18.
    Mandava SH, Serefoglu EC, Freier MT, Wilson SK, Hellstrom WJ. Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and meta-analysis. J Urol. 2012;188(5):1855–60. Epub 2012/09/25. PubMed PMID: 22999690CrossRefGoogle Scholar
  19. 19.
    Radomski SB, Herschorn S. Risk factors associated with penile prosthesis infection. J Urol. 1992;147(2):383–5. Epub 1992/02/01. PubMed PMID: 1732599CrossRefGoogle Scholar
  20. 20.
    Wilson SK, Delk JR 2nd. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol. 1995;153(3 Pt 1):659–61. Epub 1995/03/01. PubMed PMID: 7861509CrossRefGoogle Scholar
  21. 21.
    Steidle CP, Mulcahy JJ. Erosion of penile prostheses: a complication of urethral catheterization. J Urol. 1989;142(3):736–9. Epub 1989/09/01. PubMed PMID: 2769851CrossRefGoogle Scholar
  22. 22.
    Puckett CL, Montie JE. Construction of male genitalia in the transsexual, using a tubed groin flap for the penis and a hydraulic inflation device. Plast Reconstr Surg. 1978;61(4):523–30. Epub 1978/04/01. PubMed PMID: 345304CrossRefGoogle Scholar
  23. 23.
    Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973;2(1):80–2. Epub 1973/07/01. PubMed PMID: 4766860CrossRefGoogle Scholar
  24. 24.
    Frey JD, Poudrier G, Chiodo MV, Hazen A. An update on genital reconstruction options for the female-to-male transgender patient: a review of the literature. Plast Reconstr Surg. 2017;139(3):728–37. Epub 2017/02/25. PubMed PMID: 28234856CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Krishna S. Vyas
    • 1
  • Shane D. Morrison
    • 2
  • Richard A. Santucci
    • 3
  1. 1.Department of Plastic SurgeryMayo ClinicRochesterUSA
  2. 2.Division of Plastic Surgery, Department of SurgeryUniversity of Washington Medical CenterSeattleUSA
  3. 3.Crane Surgical ServicesAustinUSA

Personalised recommendations