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VR-22
(VS)
NEOPHALLOPLASTY BY CONGENITAL APHALIA USING TWO TRANSVERSE SKIN-
FLAPS: AN ALTERNATIVE APPROACH
Antonio MACEDO JUNIOR, João Luiz GOMES PARIZI, Gustavo MARCONI CAETANO MARTINS, Diego ESTEVAM OLIVEIRA,
Marcela LEAL DA CRUZ and Valdemar ORTIZ
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. We want to demonstrate in
this video a new technique of neophalloplasty based on two transverse skin flaps from lower abdominal wall.
MATERIAL AND METHODS
Patient was placed into a prone position, the urethral meatus was found inside the rectum, 2 cm from the anal border.
An ASTRA approach was performed, the urethra isolated and repositioned as a perineal urethrostomy. We created the
neophallus based on two flaps, each measured 7 x 3 cm. After incision, flaps were rotated 90 degrees and sutured one
to each other to create the neophallus. We also created a Mitrofanoff channel to secure bladder emptying in case of
urethrostomy stricture.
RESULTS
Patient had an uneventful clinical evolution, voids preferably through the urethrostomy and mother uses the Mitrofanoff
once a day. Present follow-up is 18 months.
CONCLUSIONS
We acknowledge limited clinical experience with this technique. On the other hand, the same principle has been used to
create catheterizable urinary channels with favorable results and longer follow-up. The use of transverse skin flaps
might be an interesting alternative for neophalloplasty in aphalia.