„Wahl der Lappenplastik zur Phalloplastik – was ist
                    zeitgemäßer Standard“ – Konsensus-Bericht der
                    deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren
                    Nerven und Gefäße

Lara Küenzlen; Jens Christian Wallmichrath; Markus V. Küntscher; Jens Rothenberger; Christian Laback; Dirk Johannes Schaefer; Jürgen Schaff; Ahmet Bozkurt; Gabriel Djedovic; Stefan Langer; Tobias Hirsch; Ulrich Rieger

doi:10.1055/a-2134-5891

Handchirurgie · Mikrochirurgie · Plastische Chirurgie, Table of Contents

Handchir Mikrochir Plast Chir 2023; 55(06): 427-436
DOI: 10.1055/a-2134-5891

Consensus Statement

„Wahl der Lappenplastik zur Phalloplastik – was ist zeitgemäßer Standard“ – Konsensus-Bericht der deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße

Choice of flaps for phalloplasty: what is the contemporary standard? Consensus Statement of the German-Speaking Society for Microsurgery of Peripheral Nerves and Vessels

Lara Küenzlen

¹Klinik für Plastische und Ästhetische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany

,

Jens Christian Wallmichrath

²Zentrum für Urogenitalchirurgie, Urologische Klinik München Planegg, München Planegg, Germany

,

Markus V. Küntscher

³Plastische Chirurgie, Privatpraxis für Plastische & Ästhetische Chirurgie, Hohen Neuendorf, Germany

,

Jens Rothenberger

¹Klinik für Plastische und Ästhetische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany

,

Christian Laback

⁴Klinische Abteilung für plastische, ästhetische und rekonstruktive Chirurgie, Medizinische Universität Graz, Graz, Austria

,

Dirk Johannes Schaefer

⁵Plastische-, Rekonstruktive- und Handchirurgie, Universitätsspital, Basel, Switzerland

,

Jürgen Schaff

⁶Privatklinik, Klinik Sanssouci, Potsdam, Germany

,

Ahmet Bozkurt

⁷Klinik für Plastische, Ästhetische und Handchirurgie , HELIOS Universitatsklinikum Wuppertal, Wuppertal, Germany

,

Gabriel Djedovic

⁸Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Landeskrankenhaus Feldkirch, Feldkirch, Austria

,

Stefan Langer

⁹Sektion Plastische, Ästhetische und Spezielle Handchirurgie, Universitätsklinikum Leipzig, Leipzig, Germany

,

Tobias Hirsch

¹⁰Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Fachklinik Hornheide eV, Munster, Germany

¹¹Abteilung für Plastische Chirurgie, Klinik für Unfall-, Hand- und Wiederherstellungschirugie, Universitätsklinikum Münster, Munster, Germany

,

Ulrich Rieger

¹Klinik für Plastische und Ästhetische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany

› Author Affiliations

Abstract

Zusammenfassung

Das Interesse am Aufbau eines Penoids wird von Seiten der stetig wachsenden Zahl an trans Männern wie auch der sie betreuenden Chirurgen zunehmend größer. Während die Indikation zur Operation und die positive Auswirkung der Phalloplastik auf die Lebensqualität, psychische Gesundheit und sexuelle Funktion der Patienten bereits überzeugend nachgewiesen wurde, fehlt es an Daten, die die operativen Teilschritte bewerten und vergleichen. Im Rahmen des Konsensus-Workshops der 43. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße zum Thema „Wahl der Lappenplastik zur Phalloplastik – was ist zeitgemäßer Standard?“ wurde die vorhandene Literatur diskutiert und Empfehlungen zur operativen Technik der Phalloplastik konsentiert. Die Beschlüsse für die folgenden Themen werden hier dargelegt: Auswahl der Lappenplastik zur Phalloplastik, Präoperative Diagnostik vor Phalloplastik, Urethrakonstruktion bei der Radialis- und ALT-Lappenplastik, Präformierung der Urethra am Unterarm oder Oberschenkel, Venöse Drainage der Radialislappenplastik, Innervation des Penoids, „staged“ Phalloplastik, Glansplastik und Versorgung des Hebedefektes nach Radialislappenplastik.

Abstract

The ever-expanding number of transmen as well as their surgeons share an increasing interest in the construction of a neophallus. While the indication for surgery and the positive effect of a phalloplasty on the quality of life, mental health and sexual function has already been thoroughly analysed, there is a lack of data comparing and evaluating the surgical steps. During the consensus conference on the “choice of flaps for phalloplasty” at the annual meeting of the German-Speaking Society for Microsurgery of Peripheral Nerves and Vessels, the current literature was discussed and a consensus on the surgical technique of a phalloplasty was reached. This manuscript publishes jointly developed recommendations on the following topics: choice of flaps for phalloplasty, preoperative diagnostic tests before phalloplasty, urethral construction in the radial forearm flap and anterior lateral thigh flap, preformation of the urethra at the forearm or thigh, venous drainage of the radial forearm flap, innervation of the phallus, staged phalloplasty, coronaplasty and managing the donor site of a radial forearm flap.

Schlüsselwörter

Transsexualismus - Interdisziplinäre plastische Chirurgie - Genitalien - Körperregion und Anatomie - freie Lappenplastiken - Mikrochirurgie - Phalloplastik

Key words

transsexualism - genitals - free flaps - phalloplasty

Full Text

References

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