Comparative study of three different methods for penile reconstruction

Objective To compare the effect of three methods for penile reconstruction.Methods From Sept.2000 to Dec.2012,penile reconstruction was performed in 48 cases with free scapular flap transplantation,or pedicled superficial circumflex iliac artery skin flap,or anterolateral thigh skin flap pedicled with lateral circumflex femoral artery.The flaps were 12.0-14.5 cm in length,10-12 cm in width and the urethra perimeter was about 2-3 cm.Results Free scapular flaps were used in 21 cases,with flap failure in 3 cases due to insufficient blood supply.Malleable penile prosthesis was implanted in 11 cases,which was exposed in 3 cases.Groin skin flaps were used in 21 cases,with flap failure in 8 cases due to insufficient blood supply.Malleable penile prostheses were implanted in 7 cases,which was exposed in 3 cases.Anterolateral thigh skin flaps were used in 6 cases,with flap failure in 2 cases due to necrosis and infection.No prosthesis was implanted in this group.All the failure cases underwent secondary reconstruction with successful results.37 cases were followed up for 1-6 years,avevage 2.5 years.26 cases were satisfied with the results of appearance and function.Conclusions Among these three methods,the free scapular flap is most recommended for its high survival rate,low complication rate and high patient satisfaction. Key words: Reconstruction of penis;  Surgical flaps;  Penile implantation