Congress Paper Abstract

A new concept for phalloplasty with free osteocutaneous fibula flap

Dr Jurgen Schaff, Kreisklinik Dachau - Indersdorf GmbH, Germany, with Hans Bucher MD, Stefan Gras MD and Stefan Kerscher MD. 

Email: bschaff@nw80.cip.fak14.uni-muenchen.de

The advantages of free flaps for phallopasty in female to male transsexuals are well known (Song 1982, Biemer 1988, Byun 1994). The most used procedure is the radial forearm flap. The disadvantage of this flap is the necessity of a stiffener. For this, a penis prosthesis is mostly used, which has a high rate of infection and perforation. By using the osteocutaneous fibula flap these problems can be avoided. This flap was first described for this use by Sadove (1993). In the last 5 years 12 patients underwent this method in our clinic.

The urethra was formed with the anterior vaginal flap for the pars fixa and simultaneously a split skin graft preformation of the ofc-fibula flap for the pars pendulans was done. The microvascular transfer followed 3-6 months and the final urethra anastomose 3 months later. With this method we could find a significant decrease of the rate of urethral fistulas and stenosis.

In this paper the procedure will be demonstrated, the results are presented and discussed.

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