The surgical outcomes of radial artery forearm free-flap phalloplasty in transgender men: single-centre experience and systematic review of the current literature. in International journal of impotence research / Int J Impot Res. 2020 Nov;33(7):737-745. doi: 10.1038/s41443-021-00414-x. Epub 2021 Feb 18.
2020
AOU Città della Salute di Torino
Tipo pubblicazione
Systematic Review
Autori/Collaboratori (9)Vedi tutti...
Falcone M
Department of Neurourology, Unità Spinale Unipolare, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy. marco.falcone@unito.it.
Preto M
Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy. marco.falcone@unito.it.
Timpano M
Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
et alii...
Abstract
Radial artery forearm free-flap (RAFFF) phalloplasty is considered by most authors as the gold-standard technique for genital gender-affirming surgery (GGAS). RAFFF surgical complications have rarely been investigated, and the aim of this study and literature review is to analyse and focus on the surgical technique and its postoperative vascular complications. From May 2016 to January 2020, a consecutive series of 25 transgender men who underwent GGAS were enrolled in the present study. Age, BMI and smoking habits were recorded for all patients. Overall, vascular flap complications occurred in 20% of cases. Complete flap loss due to acute arterial thrombosis was recorded in a single case (4%). In 8% of cases, limited ventro-proximal arterial ischaemia was detected, while in the remaining 8% of cases, venous ventral ischaemia was reported. These results were compared with the current literature results. Indeed, from our analysis, the number of flap veins (<2) was the only predictive factor for vascular complications. In conclusion, RAFFF represents a reliable option for total phallic construction, leading to satisfactory results in terms of flap survival. To optimize the surgical outcomes, venous vascular drainage should be recommended.
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PMID : 33603245
DOI : 10.1038/s41443-021-00414-x
Keywords
Humans; Male; Forearm/surgery; Penis/surgery; Radial Artery/surgery; Retrospective Studies; Gender-Affirming Surgery; Transgender Persons; Treatment Outcome; Female;