Penile reconstruction

Penile reconstruction

Penile reconstruction is a surgical procedure to restore form and function of the penis after injury, congenital defects, or gender-affirming surgery. It may involve:

  • Phalloplasty (construction of a penis using grafts).
  • Penile implant (for erectile function).
  • Urethral reconstruction (to restore urination).
  • Glansplasty (reshaping the tip).

Common Reasons for Reconstruction:

  1. Congenital Conditions (e.g., hypospadias, epispadias, micropenis).
  2. Trauma (accidents, burns, animal bites).
  3. Cancer Surgery (penile cancer requiring partial/total penectomy).
  4. Gender-Affirming Surgery (for transgender men).
  5. Infections (e.g., Fournier’s gangrene causing tissue loss).

Symptoms Necessitating Reconstruction

  • Painful or incomplete urination (due to urethral strictures).
  • Erectile dysfunction (from trauma or surgery).
  • Cosmetic deformity (affecting self-esteem or sexual function).
  • Inability to have penetrative sex (due to structural issues).
  • Recurrent infections (from abnormal anatomy).

Types of Penile Reconstruction

1. Phalloplasty

  • Uses skin grafts (usually from the forearm, thigh, or back) to create a neophallus.
  • May include nerve hookup for sensation and urethral lengthening for standing urination.
  • Often done in stages (e.g., RFF phalloplasty – radial forearm free flap).

2. Metoidioplasty (for transgender men)

  • Less invasive, uses existing clitoral tissue (enlarged by testosterone).
  • Allows natural erections but smaller size compared to phalloplasty.

3. Urethroplasty

  • Repairs strictures or blockages in the urethra.
  • Uses grafts from the mouth (buccal mucosa) or genital skin.

4. Penile Implants

  • Inflatable or semi-rigid rods inserted for erectile function post-reconstruction.

5. Glansplasty

  • Reshapes the penile tip for a natural appearance.

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Dr Anand Gupta

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