Glans, urethra, and corporeal body reconstruction by free osteocutaneous forearm flap transfer.

Abstract

A 30-year-old man presented with short penile corporeal bodies hosting a 3-cm fibular graft, absence of glans, and proximal penile hypospadias. The patient underwent a forearm flap transfer with an "umbrella-like" skin flap for glans and urethra reconstruction and a radial bone strut to allow for rigidity. The postoperative course was uneventful and the patient was followed-up with fluximetry tests at 2 weeks, 4 weeks, 2 months, and 6 months, showing no stenoses and normal stable values. Masturbation started at month 3 postoperatively and intercourse began at month 4, with both resulting in orgasm. At 6 months postoperatively, touch sensation, pain, and sensibility to heat were present, but sensibility to cold was absent. Light touch pressure was detected with 4.74 Semmes-Weinstein monofilament, and static two-point discrimination was 20 mm at the neoglans. One year postoperatively, a stable increased length up to 9 cm at rest and 13 cm at erection with a satisfactory anatomic definition could still be proved.