Penis Reconstruction
Penis Reconstruction
Surgery
Penis reconstruction is done in patients who have lost their penis due to accidents, violent injuries.
Penis reconstruction is done in patients who have lost their penis due to accidents, violent injuries, severe infections like necrotising fascitis or to cancer treatment.
Penis Reconstruction is usually done with the help of micro surgical techniques. The template of penis is made before hand, appropriate area is selected for its reconstruction which is usually taken from the forearm and from the lateral respect of the thigh, flap is harvested from the chosen site, transferred to the absent penile area and lastly penis is made viable with the help of microsurgery.
Penis reconstruction is a very technically demanding surgery. You should make your expectations clear to your surgeon before penis reconstruction surgery.
Ideal Reconstructed Penis
Ideally, the created penis should be aesthetically appealing, with erogenous and tactile sensation, which enables the patient to void while standing and have sexual intercourse like a natural male. All the mentioned points are difficult to achieve in all cases.
Technique of Penis Reconstruction
Penis Reconstruction is usually done by two simultaneously operating surgical teams. Lengthening of the present urethra is done by dissection between the scar, raw area is created and recipient (acceptor)vessels are dissected for anastomoses in groin region by one team. Simultaneously, radial forearm free flap is harvested from forearm or Anterolateral thigh flap from thigh to reconstruct penis. RAFFF from forearm is universally considered the gold standard in penile reconstruction. A penis with a tube-in-a-tube technique is created. After the urethra is lengthened and the acceptor (recipient) vessels dissected in the groin area, free flap is transferred to the pubic area. Urethral anastomosis and artery, veinaremicro surgically connected to the vessels in the groin.
One forearm nerve is connected to the ilioinguinal nerve for protective sensation and the other nerve of the arm is anastomosed to one of the dorsal clitoral nerves for erogenous sensation.
The defect on the forearm was covered with full-thickness skin grafts taken from the groin area or thick SSG from thigh region.
After complete recovery of 6 months, Penile Implants can be placed to maintain erections & have penetrative sex. But ideally implants should be placed in newly ceated penis when sensations have returned to the tip of the glans.
Points to remember in Penile reconstruction
- Phalloplasty helps to create a larger penis, but with a disadvantage of this new penis not becoming erectile on its own.
- It requires large number of surgical visits.
Recovery after Penis Reconstruction
You will be closely monitored as you come out of the anaesthesia. It is necessary to stay in hospital until you are sufficiently recovered to go home.
After surgery, you will be sent home usually about 10 -14 days after surgery,
- During the early stages of recovery, you will be restricted to bed rest and on injectable pain killers, antibiotics and anticoagulants to help prevent blood clots.
- All patients receive a suprapubic urinary diversion after surgery.
- All patients remain in bed during a two-week postoperative period, after which the transurethral catheter is removed. At that time, the suprapubic catheter is clamped, and voiding of urine from new penisis begun. Effective voiding might not be observed for several days. Before removal of the suprapubic catheter, a cystography with voiding urethrography is performed.
- The average hospital stay for the phalloplasty procedure is 10 – 14 days.
- By the second week you will start to feel more comfortable physically, but your recovery will take a long time. It is natural to experience pain and soreness for a long time after genital surgery.
- Surgical incisions will be monitored for scarring and infection. Your bowel movements and bladder function will be monitored.
- Most people feel well enough to get back to their usual routines within four to six weeks. By this time, normal movement should not cause any pain. In some cases, healing takes longer.
- It is important to avoid rigorous activity or exercise until full recovery.
- Tattooing of the glanscan be done after 3-months of surgery, before sensation returns to the penis.
- Sensation must be returned to the tip of the penis before the implantation of a penile erection prosthesis is done. This usually does not occur for at least a year.
Complications of Penile Reconstruction
Before going for the surgery, you should always understand the risks and potential complications related to surgery
- Risks related to anaesthesia. General Anaesthesia is very safe in present times and with best machines and a qualified anaesthetist, chances of encountering any complication are less than 0.1 percent in a healthy individual.
- The ability to void while standing is a high priority. Unfortunately, the reported incidences of urological complications, such as urethrocutaneous fistulas, stenoses, strictures, and hairy urethras are high (30%). Correction is almost always possible and up to 99% of patients have been reported able to void standing from the tip of the penis after revision surgery.
- Most complications of the radial forearm phalloplasty are related to the free tissue transfer. The whole flap can fail and would require an additional surgery.
- Risks related to Microsurgical reconstruction of flap technique like thrombosis or blood clot in the vessels of the flap, re-exploration / re-surgery to remove these clots, and flap failure is seen in less than 5 percent of cases.
- Few patients develop some degree of skin slough or partial flap necrosis. This was more often the case in smokers, in those who insisted on a large-sized penis requiring a larger flap, and also in patients having undergone anastomotic revision.
- Rare chances of infection which responds to prolonged antibiotic therapy.
- Bleeding or haematoma formation can occur which might require drainage.
- Poor wound healing because of poor blood supply of flap. Seen more commonly in smokers, diabetes, hypothyroidism and individuals with multiple comorbidities. Poor wound healing can lead to skin discoloration which can cause marginal or total skin necrosis
- Scars will be there along the incision line which will fade with time. Scars can get hypertrophied if you are prone for it.
- Rare event of Deep vein thrombosis, pulmonary or cardiac complications can occur or precipitate in patients with multiple pre-existing diseases diagnosed or undiagnosed by routinely available standard tests.
- Possibility of revision surgery.
Shaping dreams through
Know your surgeon better
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
His Credentials
Three pillars of kayakriti
Privacy
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Trust
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
Safety
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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