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Surgical Outcomes of Penile Prosthesis Implantation Surgery in Transgender Men After Phalloplasty
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersOBJECTIVES
To assess surgical outcomes of penile prosthesis implantation in transgender men who underwent phalloplasty.
PATIENTS AND METHODS
Transgender men who underwent penile prosthesis implantation after phalloplasty between January 1989 and September 2018 were retrospectively identified. A chart study was performed recording patient demographics, perioperative complications, and reoperations.
RESULTS
A total of 32 patients were identified: 22 underwent free radial forearm flap, 5 anterolateral thigh, 4 anterolateral thigh/free radial forearm flap, and 1 fibular flap phalloplasty. The median age at prosthesis implantation was 36 (range 21-59) years, the mean BMI 25.9 ± 4.0 kg/m2. At first implantation, 16 inflatable (AMS Dynaflex (n = 13), AMS Ambicor (n = 3)) and 16 malleable (Coloplast genesis (n = 14), AMS Spectra (n = 2)) prostheses were placed. Of these, 5 (16%) were removed/replaced because of infection, 2 (6%) because of leakage, 2 because of extrusion, 2 because of dislocation, 2 because of dysfunction, and 1 (3%) because of pain. The postoperative course was completely uneventful in 10 (31.3%) patients. Of all implanted prostheses, including revision procedures (n = 45), 21 (44%) were surgically replaced or removed.
CONCLUSION
Prosthesis explantation, replacement, or revision surgery occurs frequently after penile prosthesis implantation. Patients need to be well-informed preoperatively on these complication rates.
Additional Info
Disclosure statements are available on the authors' profiles:
A Retrospective Cohort Study on Surgical Outcomes of Penile Prosthesis Implantation Surgery in Transgender Men After Phalloplasty
Urology 2019 Oct 01;132(xx)195-201, WB van der Sluis, GLS Pigot, M Al-Tamimi, BL Ronkes, KB de Haseth, M Özer, JM Smit, ME Buncamper, MB BoumanFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This article highlights one of the greatest challenges in female-to-male gender-affirming surgery: offering a reliable means of penetrative intercourse after phalloplasty. Various types of penile prostheses for a variety of phalloplasty are covered in this study. The results are sobering. Of the 32 initially placed penile prostheses, 50% were removed at a median of 1.1 years, which is concordant with our experience and that of the literature. Despite numerous variations in technique and device used, the success rate of penile prosthesis placement after phalloplasty remains discouragingly low. It is a testament to importance of penetrative intercourse and the lack of reasonable alternative treatment that, despite the known risks, trans men continue to opt for prosthesis placement. Clearly, a solution to allow for penetrative intercourse after phalloplasty remains an area for scientific investigation.