Phalloplasty in Boys with Cloacal Exstrophy.

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• 作者：Piet HOEBEKE Stanislas MONSTREY ; Peter CEULEMANS ; Nicolaas LUMEN ; Katrien KLOCKAERTS ; Erik VAN LAECKE
• 刊名：Journal of Pediatric Urology
• 出版年：2008
• 出版时间：April 2008
• 年：2008
• 卷：4
• 期：Supplement 1
• 页码：S76
• 全文大小：35 K

文摘

PURPOSE

Cloacal exstrophy is considered one of the most serious congenital anomalies. Boys present with insufficient penile development and formerly female gender reassignment was considered the treatment of choice. Recently bad outcome was reported in female assigned patients, so male gender assignment is preferred (1-2). In male gender assignment subsequent phalloplasty will be necessary. Due to former surgery in the pelvic region the gold standard phalloplasty using free tissue transfer is not preferred. We therefore offered a pedicled tissue transfer (anterolateral tigh flap ALT) to 2 boys with cloacal exstrophy and raised as boys.

MATERIAL AND METHODS

Two boys, age 17 and 18 years were seen after multiple reconstructions for cloacal exstrophy. They both had an augmented bladder with closed bladder neck and continent vesicostomy. In both boys a phalloplasty was done using an ALT flap. No urethral reconstruction was done as it was uneccesary. The urethra was left open at the base of the phallus for eventual sperm evacuation.

RESULTS

Both procedures were uneventfull and in both patients a satisfactory result could be obtained. Both boys expressed their extreme hapiness with the result. Erectile devices will be implanted after 1 year.

CONCLUSIONS

With male gender assignment as gold standard approach to boys with cloacal exstrophy, we present the ALT flap as the method of choice for penile reconstruction.