The Evolution of Phalloplasty for Masculinizing Gender Affirming Surgery: A Systematic Review of Surgical Techniques and Complications Over the Past 25 Years.
Juan Diego Tinajero, Derek Gar Kit Liang, Sadia Wasay et al.
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In 30 seconds
This systematic review analyzed 45 studies on phalloplasty techniques and complications over 25 years, involving 2586 patients. It found a shift from traditional free-flap methods to more diverse approaches, with 65.3% of patients undergoing radial forearm free flap phalloplasty. Complication rates were high, averaging 0.74 and 0.66 per patient in the earlier and later groups, respectively.
Key findings
- 65.3% of patients underwent radial forearm free flap phalloplasty.
- Urethral fistulas occurred in 25.7% and 36.6% of patients in Groups 1 and 2, respectively.
- The tube-in-a-tube technique was preferred for neourethral reconstruction, with 85.8% in Group 1 and 64.4% in Group 2.
- Group 2 showed a significant increase in sensory reconstruction (p < 0.01).
Why it matters
Understanding the evolution of phalloplasty techniques and their associated complications is crucial for clinicians involved in gender-affirming surgeries. This knowledge can inform surgical decisions and improve patient outcomes.
What to keep in mind
Inconsistent outcome reporting across studies limits meaningful comparisons between techniques.