Neophalloplasty in boys with aphallia: A systematic review

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• 作者：Diego Estevam Gomes Oliveira^a ; ^{degoliveira@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Marcela Leal da Cruz^a ; Riberto Liguori^a ; Gilmar Garrone^a ; Bruno Leslie^a ; Sé ; rgio Leite Ottoni^a ; Geó ; rgia Rubiane Souza^a ; Valdemar Ortiz^a ; Roberto de Castro^b ; Antonio Macedo Jr.^a
• 关键词：Aphallia ; Penis ; Neophalloplasty ; Pediatric
• 刊名：Journal of Pediatric Urology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：12
• 期：1
• 页码：19-24
• 全文大小：523 K

文摘

Aphallia is a rare penile congenital abnormality. The aim of this systematic review was to assess all available literature on neophalloplasty in infancy with an interest in technical alternatives and clinical outcome.

Materials and methods

We performed a Pubmed search using the terms: neophalloplasty, neophallus, and phalloplasty, and selected articles that presented technical alternatives for penile construction in cases of penile dysgenesis, especially aphallia in children and/or adolescents.

Results

A total of 319 articles were identified in the initial search. Among the different techniques presented in 19 papers collected, we categorized reconstructive procedures into two groups: microsurgical and non-microsurgical techniques. Among the microsurgical techniques, procedures such as the osteocutaneous fibular flap (n = 18), the myocutaneous latissimus dorsi flap (n = 24), and the radial forearm free flap (n = 293) were reported. Among the non-microsurgical techniques, we found a wider range of technical options (6 in total). Most were based on groin, abdominal, and scrotal flaps. Long-term reports on the functionability of the neophallus and psychological aspects of the patients are lacking.

Conclusion

In assessing recent literature, it seems rational that neophalloplasty should be regarded as the preferred strategy for boys born with aphallia, in opposition to female gender assignment.