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"Bird-Wing" abdominal phalloplasty: A novel surgical technique for penile reconstruction.

Bajpai M - J Indian Assoc Pediatr Surg (2013)

Bottom Line: The patients' age ranged from 6 to 17 years with preoperative stretched penile lengths between 1 and 2.5 cm.This phalloplasty technique can be utilized as a definitive procedure in many situations of penile insufficiency.Subsequent stages of urethral repair and insertion of penile prosthesis can be easily added.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Aim: To describe a technique of phalloplasty that is devoid of donor site scarring and suitable for urethral inlay and penile prosthesis in subsequent stages in cases of aphallia.

Materials and methods: Four patients with various disorders of sex development with 46 XY and severe penile deficiency, including one with complete androgen insensitivity syndrome who was initially raised as female, have been operated using a "Bird Wing" lower abdominal skin crease incision.

Results: The patients' age ranged from 6 to 17 years with preoperative stretched penile lengths between 1 and 2.5 cm. Phallic sizes between 7.5 and 12.5 cm was achieved leaving the donor site unremarkable with lower abdominal skin crease linear scar and excellent postoperative recovery.

Conclusions: This phalloplasty technique can be utilized as a definitive procedure in many situations of penile insufficiency. Subsequent stages of urethral repair and insertion of penile prosthesis can be easily added.

No MeSH data available.


Related in: MedlinePlus

Vascular supply to the “bird wing abdominal flaps.” Abbreviations: ASIS-anterior superior iliac spine; SCIA—superficial circumflex iliac artery; DCIA—deep circumflex iliac artery; SIEA—superficial inferior epigastric artery
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Figure 1: Vascular supply to the “bird wing abdominal flaps.” Abbreviations: ASIS-anterior superior iliac spine; SCIA—superficial circumflex iliac artery; DCIA—deep circumflex iliac artery; SIEA—superficial inferior epigastric artery

Mentions: Technique: Abdominal flap demarcation: Under general anesthesia, patient is placed in lithotomy position. Urethral lumen is catheterized easily by inserting a Foley's catheter. A “bird wing” incision was marked with its base in suprapubic/mons pubic location and lateral extensions up to lower abdominal skin crease extending to both flanks [Figure 1]. The base to limb ratio of the flaps is kept at 4 or 5: 1, so that adequate blood supply is ensured to the most distal end. It may be noted that a unique feature of this flap design is the common base which sustains blood supply to both the flaps [Figures 1 and 2a]. The depth of the incision reaches up to the anterior rectus sheath and the external oblique aponeurosis, from medial to lateral. Thus, the blood supply of this region is provided by superficial epigastric and circumflex iliac vessels. Abdominal “flap-apposition” and phalloplasty: Both lateral “wings” are approximated in the midline using subcuticular sutures [Figure 2b].


"Bird-Wing" abdominal phalloplasty: A novel surgical technique for penile reconstruction.

Bajpai M - J Indian Assoc Pediatr Surg (2013)

Vascular supply to the “bird wing abdominal flaps.” Abbreviations: ASIS-anterior superior iliac spine; SCIA—superficial circumflex iliac artery; DCIA—deep circumflex iliac artery; SIEA—superficial inferior epigastric artery
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3687145&req=5

Figure 1: Vascular supply to the “bird wing abdominal flaps.” Abbreviations: ASIS-anterior superior iliac spine; SCIA—superficial circumflex iliac artery; DCIA—deep circumflex iliac artery; SIEA—superficial inferior epigastric artery
Mentions: Technique: Abdominal flap demarcation: Under general anesthesia, patient is placed in lithotomy position. Urethral lumen is catheterized easily by inserting a Foley's catheter. A “bird wing” incision was marked with its base in suprapubic/mons pubic location and lateral extensions up to lower abdominal skin crease extending to both flanks [Figure 1]. The base to limb ratio of the flaps is kept at 4 or 5: 1, so that adequate blood supply is ensured to the most distal end. It may be noted that a unique feature of this flap design is the common base which sustains blood supply to both the flaps [Figures 1 and 2a]. The depth of the incision reaches up to the anterior rectus sheath and the external oblique aponeurosis, from medial to lateral. Thus, the blood supply of this region is provided by superficial epigastric and circumflex iliac vessels. Abdominal “flap-apposition” and phalloplasty: Both lateral “wings” are approximated in the midline using subcuticular sutures [Figure 2b].

Bottom Line: The patients' age ranged from 6 to 17 years with preoperative stretched penile lengths between 1 and 2.5 cm.This phalloplasty technique can be utilized as a definitive procedure in many situations of penile insufficiency.Subsequent stages of urethral repair and insertion of penile prosthesis can be easily added.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Aim: To describe a technique of phalloplasty that is devoid of donor site scarring and suitable for urethral inlay and penile prosthesis in subsequent stages in cases of aphallia.

Materials and methods: Four patients with various disorders of sex development with 46 XY and severe penile deficiency, including one with complete androgen insensitivity syndrome who was initially raised as female, have been operated using a "Bird Wing" lower abdominal skin crease incision.

Results: The patients' age ranged from 6 to 17 years with preoperative stretched penile lengths between 1 and 2.5 cm. Phallic sizes between 7.5 and 12.5 cm was achieved leaving the donor site unremarkable with lower abdominal skin crease linear scar and excellent postoperative recovery.

Conclusions: This phalloplasty technique can be utilized as a definitive procedure in many situations of penile insufficiency. Subsequent stages of urethral repair and insertion of penile prosthesis can be easily added.

No MeSH data available.


Related in: MedlinePlus