ADDRESSING THE IDEAL REQUIREMENTS BY FREE-FLAP PHALLOPLASTY - SOME REFLECTIONS ON REFINEMENTS OF TECHNIQUE

Ideally, in phalloplasty one should aim at 1) a one-stage procedure th at can be predictably reproduced, 2) creation of a competent neo-ureth ra to allow for voiding while standing, 3) return of both tactile and erogenous sensibility, 4) enough bulk to tolerate the insertion of a p rosthetic stiffener, and 5) a result that is aesthetically acceptable to the patient. We consider 6) minimal scarring or disfigurement, and 7) no functional loss in the donor area further requirements for any i deal procedure. Thanks to ongoing refinements, microsurgical free flap phalloplasty techniques lead to the best results, both functionally a nd cosmetically. These refinements are presented and discussed, as are our experiences applying them. (C) 1993 Wiley-Liss, Inc.