Phalloplasty and urethroplasty in a boy with penile agenesis

• Autor(a) principal: De Castro, Roberto
• Data de Publicação: 2013
• Outros Autores: Rondon, Atila [UNIFESP], Barroso, Ubirajara, Ortiz, Valdemar [UNIFESP], Macedo, Antonio
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1016/j.jpurol.2012.09.001; http://repositorio.unifesp.br/handle/11600/35891
• topic: Penile agenesis; Penis; Male; Phalloplasty; Aphallia

Objective: New concepts in ambiguous genitalia have questioned the strategy of female gender reassignment in cases of penile agenesis. Hence, we present a video of the construction of a phallus according to the de Castro technique as an alternative approach for this devastating condition.Methods: A 12-year-old boy with congenital penile agenesis and posterior urethra emerging in the distal rectum was selected. An ASTRA approach was used and a phallus was constructed with a skin flap from the abdominal wall, tubularized to produce a phallic appearance. A buccal mucosa graft was tubularized to create the new urethra.Results: Immediate outcome was excellent. Partial dehiscence of the dorsal urethral sutures occurred and the patient started voiding through a scrotal urethrostomy at 9 months postoperatively. Phalloplasty provided an adequate male appearance with a good cosmetic aspect.Conclusion: the technique is a feasible alternative. A procedure in 2 stages by first creating the neourethra at a later date might be an interesting option to try to avoid the urethral complications observed. Long-term follow-up is however necessary to confirm the initial results. (c) 2012 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved.