Complete phalloplasty using the free radial forearm flap for correcting micropenis associated with vesical exstrophy

Purpose: We present a new surgical technique for reconstructing the penis i n a man with micropenis associated with vesical exstrophy. Materials and Methods: A free radial forearm flap was used to create a peni s of normal length and diameter. The flap was wrapped around the native mic ropenis. A penile prosthesis was then inserted in the flap to provide erect ion. Results: The flap was well vascularized and no skin damage was observed 6 y ears after reconstruction. The patient achieved sexual intercourse on a reg ular basis. He is satisfied with the result. Conclusions: Free transfer of the radial forearm flap may be done in select men with micropenis associated with vesical exstrophy for penile reconstru ction. An inflatable prosthesis may be inserted in the flap to provide erec tion. The results of this technique have remained stable in the long term. This method provides a new tool for phalloplasty in these difficult cases.