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Latissimus dorsi free flap phalloplasty: a systematic review

International Journal of Impotence Research volume 33, pages 746–753 (2021)Cite this article

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Abstract

A phalloplasty is a complex genital reconstruction procedure of creating a neophallus. Several techniques to create a neophallus are described, based on different vascularized flaps, and each of them has its advantages and drawbacks. The aim of this study is to present musculocutaneous latissimus dorsi (MLD) flap as a viable option for total phalloplasty, with an interest in clinical outcomes and complications. A comprehensive literature review of all available reports about MLD flap phalloplasty was made. The following keywords were used on PubMed: latissimus dorsi musculocutaneous/myocutaneous free flap and phalloplasty. Research criteria revealed five articles and the results of 182 patients were analyzed. A total number of the patients, indications, operative technique, follow-up period, postoperative results, and complications were presented. In conclusion, MLD free flap presents a good choice for phalloplasty providing sufficient amount of tissue for safe implantation of penile prosthesis and successful penetrative sexual intercourse. The erogenous sensitivity is preserved with clitoris or glans penis incorporated into the base of the neophallus, and voiding in a standing position is achievable after urethral reconstruction. The main drawback is the lack of tactile sensation of the neophallus and the significant advantage is a well-concealed donor site.

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Fig. 1: Flap design.
Fig. 2
Fig. 3: The appearance of the neophallus after MLD phalloplasty.
Fig. 4: Scar of the donor area.

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Authors and Affiliations

  1. Institute for Mother and Child Health Care of Serbia “Dr Vukan Cupic”, Belgrade, Serbia

    Vladimir Kojovic, Marko Marjanovic, Ana Radenkovic, Predrag Ilic & Radoje Simic

  2. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Vladimir Kojovic, Predrag Ilic & Radoje Simic

  3. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Branko Bojovic

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Kojovic, V., Marjanovic, M., Radenkovic, A. et al. Latissimus dorsi free flap phalloplasty: a systematic review. Int J Impot Res 33, 746–753 (2021). https://doi.org/10.1038/s41443-020-00371-x

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