Aphalia Penis Reconstruction With Tubing Radial Forearm Free Flap : A Case Report
Muhammad Irzal Wahab1, Sitti Rizaliyana2

Department of Plastic Reconstructive and Aesthetic Surgery, Airlangga University School of Medicine / Dr. Soetomo General Hospital Surabaya

Abstract

Background: Aphallia Penis or penile agenesis is a condition where no penis is found in a man. This is caused by the failure of the development of the genital tubercle. This disorder is very rare, with an estimated incidence of 1 in 10 million to 30 million births. Treatment for aphallia must begin as early as possible, based on careful evaluation and rapid sex determination by the clinical team, including plastic surgeons, psychologists, endocrinologists and urologists.
Case: A man, 22 years-old-patient, from Bali came to the Reconstructive and Aesthetic Plastic Surgery Polyclinic Dr. Soetomo, Surabaya with the main complaint of not having male genitals from birth. The patient has been urinating through a hole under the clear yellow scrotum. Three operations have been carried out to reconstruct the penis.
Discussion: In this case, the patient had reconstruction for aphalia penis. Three operations were performed. The first is a uretroplasty surgery in which the operation of the removal of the external urethra meatus from the perineal to the penoscrotal area The second stage of surgery was performed neorethra exploration in the antebrachial region, external genital reconstruction with radial forearm free flap sinister tubes, silicone implant insertions, Neophalus insertions, and split thickness skin grafts to close the defects in the antebrachia. In third stage surgery, uretroplasty surgery is performed again to move the external urethra meatus in the penoscrotal distal to the penis.

Conclusions: Treatment for aphallia must begin as early as possible, based on careful evaluation and rapid sex determination by the clinical team, including plastic surgeons, psychologists, endocrinologists and urologists. After sex determination and consultation with a psychologist, after adulthood can be carried out a total phallic reconstruction using radial artery-based free forearm flaps or with pedicled anterolateral thigh flaps, where this method is known as a simple, fast, and

Keywords: Aphalia Penis, Tubing Radial Forearm Free Flap, Phallus Reconstruction.

Topic: Clinical Practice in Pandemic Era