Faculty, Staff and Student Publications
Publication Date
8-31-2023
Journal
Translational Andrology and Urology
Abstract
Placement of an inflatable penile prosthesis (IPP) in a transgender patient’s neophallus carries unique considerations versus cis-gender IPP placement in mitigating infection, erosion, and overall complication rates. An example of this includes the lack of an anatomical corpus cavernosum and crura for cylinder placement and anchoring. Multiple grafting approaches and materials have been utilized to mitigate possible cylinder instability and improve anchoring. Here we describe our experience and surgical technique in IPP neophallus placement utilizing a single cylinder with distal and proximal cylinder human cadaver pericardium (Tutoplast®, IOP Ophthalmics, Costa Mesa, CA, USA) grafts. Our goals were to determine postoperative satisfaction and device functionality in patients undergoing transgender neophallus IPP placement using our technique. Both patients report satisfaction and no complications at last follow-up (currently up to 14 and 23 months post-operatively, respectively) with satisfactory erectile function and ability to perform penetrative intercourse. In neophallus IPP placement, the anatomical differences compared to cis-gender IPP operations require unique considerations such as cylinder grafting material selection for proximal cylinder fixation and mitigation of device erosion rates. Optimization of grafting material in neophallus IPP placement in an effort to reduce erosion rates has become increasingly important as frequency of this operation increases. Utilizing human cadaver pericardium graft in distal and proximal cylinder coverage shows beneficial preliminary outcomes in our patients.
Keywords
Inflatable penile prosthesis (IPP), transgender neophallus, gender affirming surgery, phalloplasty, Tutoplast® pericardium graft
DOI
10.21037/tau-22-837
PMID
37680230
PMCID
PMC10481199
PubMedCentral® Posted Date
8-10-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes