Semin Plast Surg 2011; 25(3): 221-228
DOI: 10.1055/s-0031-1281492
© Thieme Medical Publishers

Penile Reconstruction

Christopher J. Salgado1 , Harvey Chim2 , Jennifer C. Tang1 , Stan J. Monstrey3 , Samir Mardini4
  • 1Division of Plastic Surgery, Miller School of Medicine, University of Miami, Miami, Florida
  • 2Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio
  • 3Department of Plastic Surgery, University Hospital Gent, Gent, Belgium
  • 4Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
Weitere Informationen


03. September 2011 (online)


A variety of surgical options exists for penile reconstruction. The key to success of therapy is holistic management of the patient, with attention to the psychological aspects of treatment. In this article, we review reconstructive modalities for various types of penile defects inclusive of partial and total defects as well as the buried penis, and also describe recent basic science advances, which may promise new options for penile reconstruction.


  • 1 Schonfeld W, Beebe G W. Normal growth and variation in the male genitalia from birth to maturity.  J Urol. 1942;  48 759
  • 2 Spyropoulos E, Borousas D, Mavrikos S, Dellis A, Bourounis M, Athanasiadis S. Size of external genital organs and somatometric parameters among physically normal men younger than 40 years old.  Urology. 2002;  60 (3) 485-489 discussion 490-491
  • 3 Amukele S A, Lee G W, Stock J A, Hanna M K. 20-year experience with iatrogenic penile injury.  J Urol. 2003;  170 (4 Pt 2) 1691-1694
  • 4 Ghanem H, Shamloul R, Khodeir F, ElShafie H, Kaddah A, Ismail I. Structured management and counseling for patients with a complaint of a small penis.  J Sex Med. 2007;  4 (5) 1322-1327
  • 5 Alter G J. Penile enlargement surgery.  Tech Urol. 1998;  4 (2) 70-76
  • 6 Zhao Y Q, Zhang J, Yu M S, Long D C. Functional restoration of penis with partial defect by scrotal skin flap.  J Urol. 2009;  182 (5) 2358-2361
  • 7 Mazza O N, Cheliz G M. Glanuloplasty with scrotal flap for partial penectomy.  J Urol. 2001;  166 (3) 887-889
  • 8 Salgado C J, Chim H, Rowe D, Bodner D R. Vascularized cadaveric fibula flap for treatment of erectile dysfunction following failure of penile implants.  J Sex Med. 2010;  7 (10) 3504-3509
  • 9 Micheli E, Ranieri A, Peracchia G, Lembo A. End-to-end urethroplasty: long-term results.  BJU Int. 2002;  90 (1) 68-71
  • 10 Guralnick M L, Webster G D. The augmented anastomotic urethroplasty: indications and outcome in 29 patients.  J Urol. 2001;  165 (5) 1496-1501
  • 11 El-Kassaby A W, El-Zayat T M, Azazy S, Osman T. One-stage repair of long bulbar urethral strictures using augmented Russell dorsal strip anastomosis: outcome of 234 cases.  Eur Urol. 2008;  53 (2) 420-424
  • 12 Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique?.  J Urol. 2005;  174 (3) 955-957 discussion 957-958
  • 13 Nuhu A, Edino S T, Agbese G O, Kallamu M. Penile gangrene due to strangulation by a metallic nut: a case report.  West Afr J Med. 2009;  28 (5) 340-342
  • 14 Gyan S, Sushma S, Maneesh S, Rajesh S, Misra M. Successful microsurgical penile replantation following self amputation in a schizophrenic patient.  Indian J Urol. 2010;  26 (3) 434-437
  • 15 Puckett C L, Montie J E. Construction of male genitalia in the transsexual, using a tubed groin flap for the penis and a hydraulic inflation device.  Plast Reconstr Surg. 1978;  61 (4) 523-530
  • 16 Chang T S, Hwang W Y. Forearm flap in one-stage reconstruction of the penis.  Plast Reconstr Surg. 1984;  74 (2) 251-258
  • 17 Garaffa G, Christopher N A, Ralph D J. Total phallic reconstruction in female-to-male transsexuals.  Eur Urol. 2010;  57 (4) 715-722
  • 18 Monstrey S, Hoebeke P, Selvaggi G et al.. Penile reconstruction: is the radial forearm flap really the standard technique?.  Plast Reconstr Surg. 2009;  124 (2) 510-518
  • 19 Song C, Wong M, Wong C H, Ong Y S. Modifications of the radial forearm flap phalloplasty for female-to-male gender reassignment.  J Reconstr Microsurg. 2011;  27 (2) 115-120
  • 20 Monstrey S, Hoebeke P, Dhont M et al.. Radial forearm phalloplasty: A review of 91 cases.  ANIR-ANHP. 2004;  6 193-199
  • 21 Waits C A, Toby E B, Girod D A, Tsue T T. Osteocutaneous radial forearm free flap: long-term radiographic evaluation of donor site morbidity after prophylactic plating of radius.  J Reconstr Microsurg. 2007;  23 (7) 367-372
  • 22 Hu Z Q, Hyakusoku H, Gao J H, Aoki R, Ogawa R, Yan X. Penis reconstruction using three different operative methods.  Br J Plast Surg. 2005;  58 (4) 487-492
  • 23 Mutaf M. Nonmicrosurgical use of the radial forearm flap for penile reconstruction.  Plast Reconstr Surg. 2001;  107 (1) 80-86
  • 24 Sadove R C, McRoberts J W. Total phallic reconstruction with the free fibula osteocutaneous flap.  Plast Reconstr Surg. 1992;  89 (5) 1001
  • 25 Schaff J, Papadopulos N A. A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: experience in 37 patients.  Microsurgery. 2009;  29 (5) 413-419
  • 26 Mutaf M, Isik D, Bulut O, Büyükgüral B. A true one-stage nonmicrosurgical technique for total phallic reconstruction.  Ann Plast Surg. 2006;  57 (1) 100-106
  • 27 Rubino C, Figus A, Dessy L A et al.. Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals.  J Plast Reconstr Aesthet Surg. 2009;  62 (3) e45-e49
  • 28 Lee G K, Lim A F, Bird E T. A novel single-flap technique for total penile reconstruction: the pedicled anterolateral thigh flap.  Plast Reconstr Surg. 2009;  124 (1) 163-166
  • 29 Felici N, Felici A. A new phalloplasty technique: the free anterolateral thigh flap phalloplasty.  J Plast Reconstr Aesthet Surg. 2006;  59 (2) 153-157
  • 30 Lin C T, Chen L W. Using a free thoracodorsal artery perforator flap for phallic reconstruction—a report of surgical technique.  J Plast Reconstr Aesthet Surg. 2009;  62 (3) 402-408
  • 31 Bettocchi C, Ralph D J, Pryor J P. Pedicled pubic phalloplasty in females with gender dysphoria.  BJU Int. 2005;  95 (1) 120-124
  • 32 Hu W, Lu J, Zhang L et al.. A preliminary report of penile transplantation.  Eur Urol. 2006;  50 (4) 851-853
  • 33 Pestana I A, Greenfield J M, Walsh M, Donatucci C F, Erdmann D. Management of “buried” penis in adulthood: an overview.  Plast Reconstr Surg. 2009;  124 (4) 1186-1195
  • 34 Ehrilch R M, Alter G J. Buried penis. In: Ehrlich R M, Alter G J, eds. Reconstructive and Plastic Surgery of the External Genitalia: Adult and Pediatric. Vol. 1. Philadelphia: Saunders; 1999: 397-401
  • 35 Alter G J. Surgical techniques: surgery to correct hidden penis.  J Sex Med. 2006;  3 (5) 939-942
  • 36 Chen K L, Eberli D, Yoo J J, Atala A. Bioengineered corporal tissue for structural and functional restoration of the penis.  Proc Natl Acad Sci U S A. 2010;  107 (8) 3346-3350
  • 37 Yoo J J, Park H J, Lee I, Atala A. Autologous engineered cartilage rods for penile reconstruction.  J Urol. 1999;  162 (3 Pt 2) 1119-1121
  • 38 Kim B S, Yoo J J, Atala A. Engineering of human cartilage rods: potential application for penile prostheses.  J Urol. 2002;  168 (4 Pt 2) 1794-1797
  • 39 Nolazco G, Kovanecz I, Vernet D et al.. Effect of muscle-derived stem cells on the restoration of corpora cavernosa smooth muscle and erectile function in the aged rat.  BJU Int. 2008;  101 (9) 1156-1164
  • 40 Song Y S, Lee H J, Park I H, Kim W K, Ku J H, Kim S U. Potential differentiation of human mesenchymal stem cell transplanted in rat corpus cavernosum toward endothelial or smooth muscle cells.  Int J Impot Res. 2007;  19 (4) 378-385

Christopher J SalgadoM.D. 

Miller School of Medicine, University of Miami, Holtz Children's Center – ET 3019

1611 NW 12th Avenue, Miami, FL 33136