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Phalloplasty (edit)

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{{Content warning|genitals, reproductive organs, and surgery}}
{{Content warning|genitals, reproductive organs, and surgery}}


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{{Template:Surgeries}}
{{Template:Surgeries}}
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A 3-cm scrotal incision is made on the penoscrotal raphe and carried down through the subcutaneous tissue to the Buck's fascia. A Scott retractor, a flexible device that holds open the skin of the surgical site, is applied to the area.
A 3-cm scrotal incision is made on the penoscrotal raphe and carried down through the subcutaneous tissue to the Buck's fascia. A Scott retractor, a flexible device that holds open the skin of the surgical site, is applied to the area.


Up until this stage of the surgery, the process has been consistent with the sanitary practices associated with standard surgical sterility.<ref>Richard Pearcy & Raj Persad, publication date unknown, "Inflatable penile prosthesis," in BJU International Website Atlas of Surgery and Surgical Devices, see [http://www.bjui.org/%5CBJUI_IMAGES%5CSurgicalAtlas%5C234Inflatable%20www%20MD%20formatted.pdf], accessed 31 May 2014 [https://web.archive.org/web/20230404151137/http://www.bjui.org//BJUI_IMAGES/SurgicalAtlas/234Inflatable%20www%20MD%20formatted.pdf Archived] on 17 July 2023</ref> At this stage of the "No-Touch" Technique, after the incision has been made, all instruments, including surgical gloves that have touched skin are discarded. A loose drape is then deployed over the entire surgical field and secured at the periphery with adhesive strips. A small opening in the drape is then made overlying the incision and yellow hooks utilized to secure the edges of the opening to the edges of the incision, completely covering and isolating the patient's skin.  At this point, new instruments and equipment are replaced and the entire prosthesis is inserted through the small opening of the loose drape. The loose drape allows for manipulation of the penis and scrotum required for this procedure without touching the skin.
Up until this stage of the surgery, the process has been consistent with the sanitary practices associated with standard surgical sterility.<ref>Richard Pearcy & Raj Persad, publication date unknown, "Inflatable penile prosthesis," in BJU International Website Atlas of Surgery and Surgical Devices, see [https://web.archive.org/web/20140323194926/http://www.bjui.org/%5CBJUI_IMAGES%5CSurgicalAtlas%5C234Inflatable%20www%20MD%20formatted.pdf], accessed 31 May 2014 [https://web.archive.org/web/20230404151137/http://www.bjui.org//BJUI_IMAGES/SurgicalAtlas/234Inflatable%20www%20MD%20formatted.pdf Archived] on 17 July 2023</ref> At this stage of the "No-Touch" Technique, after the incision has been made, all instruments, including surgical gloves that have touched skin are discarded. A loose drape is then deployed over the entire surgical field and secured at the periphery with adhesive strips. A small opening in the drape is then made overlying the incision and yellow hooks utilized to secure the edges of the opening to the edges of the incision, completely covering and isolating the patient's skin.  At this point, new instruments and equipment are replaced and the entire prosthesis is inserted through the small opening of the loose drape. The loose drape allows for manipulation of the penis and scrotum required for this procedure without touching the skin.


Implantation of the device continues with an incision and dilation of corpora, sizing and placing the penile cylinders, and placement of the pump in the scrotum and the reservoir in the retropubic space.  Saline is used throughout the implantation for irrigation. Once the corporotomies are closed and all of the tubing and components of the prosthesis covered with a layer of Buck's fascia, subcutaneous tissues are closed and the "No-Touch" drape is removed and the skin closed.<ref name="Eid 2011 5-8" />
Implantation of the device continues with an incision and dilation of corpora, sizing and placing the penile cylinders, and placement of the pump in the scrotum and the reservoir in the retropubic space.  Saline is used throughout the implantation for irrigation. Once the corporotomies are closed and all of the tubing and components of the prosthesis covered with a layer of Buck's fascia, subcutaneous tissues are closed and the "No-Touch" drape is removed and the skin closed.<ref name="Eid 2011 5-8" />
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* [https://archive.today/20121021165141/http://www3.interscience.wiley.com/journal/121581796/abstract Use of forearm free-flap phalloplasty in bladder exstrophy adults] by Marc-Olivier  Timsit, Pierre Mouriquand, Alain  Ruffion, Alain  Bouillot, Diala  Dembelé, Arnaud  Mejean, Fanny  Lalloue, Albert  Leriche and Nicolas Morel-Journel (BJU International, Volume 103 Issue 10, Dec 2008)
* [https://archive.today/20121021165141/http://www3.interscience.wiley.com/journal/121581796/abstract Use of forearm free-flap phalloplasty in bladder exstrophy adults] by Marc-Olivier  Timsit, Pierre Mouriquand, Alain  Ruffion, Alain  Bouillot, Diala  Dembelé, Arnaud  Mejean, Fanny  Lalloue, Albert  Leriche and Nicolas Morel-Journel (BJU International, Volume 103 Issue 10, Dec 2008)
* {{cite journal|title=Phalloplasty for female transsexuals with sensate free forearm flap|doi=10.1002/micr.1920150512 |journal=Microsurgery| volume=15| issue=5|date=1994}} by Rong-Hwang Fang, Jin-Teh Lin, Shiuh Ma (Microsurgery, Volume 15 Issue 5)
* {{cite journal|title=Phalloplasty for female transsexuals with sensate free forearm flap|doi=10.1002/micr.1920150512 |journal=Microsurgery| volume=15| issue=5|date=1994}} by Rong-Hwang Fang, Jin-Teh Lin, Shiuh Ma (Microsurgery, Volume 15 Issue 5)
* {{cite journal |url=https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2008.08286.x |title=Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism |journal=BJU International |volume=101 |issue=10 |date=Jan 2008 |doi=10.1111/j.1464-410X.2008.08286.x |authors=Albert  Leriche, Marc-Olivier Timsit, Nicolas Morel-Journel, André Bouillot, Diala Dembele and Alain Ruffion|archive-url=False |archive-date=17 July 2023 }}  
* {{cite journal |url=https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2008.08286.x |title=Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism |journal=BJU International |volume=101 |issue=10 |date=Jan 2008 |doi=10.1111/j.1464-410X.2008.08286.x |authors=Albert  Leriche, Marc-Olivier Timsit, Nicolas Morel-Journel, André Bouillot, Diala Dembele and Alain Ruffion |archive-url=https://web.archive.org/web/20230721221515/https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2008.08286.x |archive-date=21 July 2023 |access-date=29 November 2020 |url-status=bot: unknown }}  
* [http://journals.lww.com/plasreconsurg/Abstract/2009/08000/Penile_Reconstruction__Is_the_Radial_Forearm_Flap.22.aspx Penile Reconstruction: Is the Radial Forearm Flap Really the Standard Technique?] by Monstrey, Stan; Hoebeke, Piet; Selvaggi, Gennaro; al etc. (Journal of Plastic and Reconstructive Surgery, Volume 124 Issue 2, August 2009)
* [http://journals.lww.com/plasreconsurg/Abstract/2009/08000/Penile_Reconstruction__Is_the_Radial_Forearm_Flap.22.aspx Penile Reconstruction: Is the Radial Forearm Flap Really the Standard Technique?] by Monstrey, Stan; Hoebeke, Piet; Selvaggi, Gennaro; al etc. (Journal of Plastic and Reconstructive Surgery, Volume 124 Issue 2, August 2009)
* {{cite journal |url=https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.1920140910 |title=Addressing the ideal requirements by free flap phalloplasty: Some reflections on refinements of technique |journal=Microsurgery |volume=14 |issue=9|date=1993 |authors= |doi=10.1002/micr.1920140910|archive-url=https://web.archive.org/web/20210702181311/https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.1920140910 |archive-date=17 July 2023 }}
* {{cite journal |url=https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.1920140910 |title=Addressing the ideal requirements by free flap phalloplasty: Some reflections on refinements of technique |journal=Microsurgery |volume=14 |issue=9|date=1993 |authors= |doi=10.1002/micr.1920140910|archive-url=https://web.archive.org/web/20210702181311/https://onlinelibrary.wiley.com/doi/abs/10.1002/micr.1920140910 |archive-date=17 July 2023 }}
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