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PENILE PROSTHESIS IMPLANTATION IN A PATIENT WITH CONGENITAL
APHALIA TREATED BY DE CASTRO TECHNIQUE TEN YEARS AGO. IS IT FEASIBLE?
Antonio MACEDO JR, Jhonson JOAQUIM GOUVÊA, Gilmar GARRONE, Gustavo Marconi CAETANO MARTINS, João PARIZI,
Marcela LEAL DA CRUZ, Diego Estevam GOMES OLIVEIRA and Sérgio LEITE OTTONI
Universidade Federal de São Paulo, Pediatric Urology, São Paulo, BRAZIL
PURPOSE
Penile agenesis is a rare congenital abnormality with an incidence of 1 in 30 million births. The aim of this video is to
demonstrate penile prosthesis implantation in a young adult, born with aphalia that underwent De Castro
neophaloplastia in childhood.
MATERIAL AND METHODS
A boy born with aphalia underwent at age of 11 years a De Castro neophalloplasty at our institution. He had a
satisfactory clinical outcome, reported no psychological complaints and other findings. After nine years of surgery, he
looked for alternatives to start sexual activity. After measuring his neo-phallus we found 13 cm of lenght. We proposed
him penile prosthesis implantation. Through a perineal incision we constructed a tunnel up to the distal portion of the
neophallus. We encircled one semi-rigid component of the prosthesis into a polypropylene mesh, that was sutured to
periosteum of inferioir pubic arch to give support to the prosthesis.
RESULTS
The patient had an excellent outcome and awaits longer followup to start sexual intercourse.
CONCLUSIONS
We were able to attest clinical feasibility of prosthesis implantation by neophalloplasty at infancy due to congenital
aphalia. We believe that this procedure will confirm the hyphotesis that this rare abnormality can be treated accordingly
without promoting gender reassingment. Further psychological analysis will confirm if those patients can have also a
pleasant sexual history.