Schirmann, A, Cao, YQ, Christopher, N, Ralph, D, Lee, W

Micropenis, anterolateral thigh flap, phalloplasty, penile reconstruction

The aim of this video is to illustrate the technique for penile reconstruction using a pedicled anterolateral thigh (ALT) flap without integrated urethra in a 21-year-old man with micropenis and hypospadias from a disorder of sexual differentiation (46XY).

The most common flap used for phalloplasty is the radial artery forearm free flap phalloplasty (RAP). This video highlights that ALT is a good and safe alternative. Indeed, pedicled flaps do not require microvascular anastomosis and therefore have a lower risk of vascular compromise compared to RAP.

The full technique is demonstrated in live surgery.

Harris T.G.W, Manyevitch R, Wu W.J, Leto Barone A.A, Bivalacqua T.J, Burnett A.L, Gearhart J.P, Redett R.J. Pedicled Anterolateral Thigh and Radial Forearm Free Flap Phalloplasty for Penile Reconstruction in Patients With Bladder Exstrophy, J Urol, 2021;205(3):880-887