{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:36:35Z","timestamp":1785418595164,"version":"3.56.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Radial forearm free flap phalloplasty (RFFF) is a set of complex reconstructive procedures aimed at creating an aesthetic and functional penis in transgender patients. Sensory recovery in the neophallus and donor site is crucial for optimizing outcomes, but the few prior studies that exist assess neophallus sensation at limited locations and time points. The purpose of this study was to prospectively quantify sensory outcomes in the neophallus and donor site following RFFF phalloplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sensation testing occurred prospectively over February 2019\u2013January 2021 on Stage 1 RFFF phalloplasty patients using the Pressure Specified Sensory Device (PSSD). On the neophallus, one\u2010point discrimination (1PS) pressure threshold and lengthwise sensory recovery were measured at six circumferential locations proximally to distally. On the donor site, 1PS was measured at three locations on the donor hand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen patients were included (average age 34.0\u2009years old, range 18\u201353\u2009years). Among patients that received neophallus testing (<jats:italic>n<\/jats:italic>\u2009=\u200913), eight had at least two follow\u2010up appointments. Six of these patients had sensation as of their most recent measurement (75.0%), with an average of 73\u2009days to regain sensation. There was a significantly greater proportion of patients with sensation at the right ventral (80.0% after 3\u2009months vs. 11.1%\u201360.0% before 3\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u20090.024) and right lateral (100.0% after 3\u2009months vs. 11.1%\u201360.0% before 3\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u20090.004) aspects of the neophallus over time. Pressure required to elicit sensation decreased by 18.0% from 1\u2009week\u20131\u2009month postoperatively to 3\u20137.7\u2009months postoperatively in the right ventral neophallus (96.2 g\/mm<jats:sup>2<\/jats:sup>\u2009\u00b1\u200911.3\u2009g\/mm<jats:sup>2<\/jats:sup> to 56.6\u2009\u00b1\u200939.9\u2009g\/mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.037). Among patients that received donor site testing (<jats:italic>n<\/jats:italic>\u2009=\u200911), mixed effects regression analysis with random intercepts demonstrated significant changes in the thumb (3.4\u2009g\/mm<jats:sup>2<\/jats:sup> \u00b1\u20091.4\u2009g\/mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and webspace (13.5\u2009g\/mm<jats:sup>2<\/jats:sup> \u00b1\u20094.9\u2009g\/mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) that returned to baseline at 3\u2009months postoperatively (1.7\u2009g\/mm<jats:sup>2<\/jats:sup>\u2009\u00b1\u20091.0\u2009g\/mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05, and 2.3\u2009g\/mm<jats:sup>2<\/jats:sup>\u2009\u00b1\u20094.0\u2009g\/mm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This pilot study demonstrates that quantitative sensory testing can be used to monitor post\u2010phalloplasty sensory changes. Recovery was significantly associated with contralateral (i.e, right side in a left forearm RFF) aspects of the neophallus, suggesting a possible pattern of circumferential sensory innervation via RFFF sensory nerves. Future studies with a larger sample size and longer follow\u2010ups are necessary to fully characterize sensory recovery in phalloplasty patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31228","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T10:25:48Z","timestamp":1725618348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early Penile and Donor Site Sensory Outcomes After Innervated Radial Forearm Free Flap Phalloplasty: A Pilot Prospective Study"],"prefix":"10.1002","volume":"44","author":[{"given":"Sophia","family":"Hu","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Oles","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Johns Hopkins University School of 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 Annapolis Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Noyes","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin\u00a0R.","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Parisi","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti","family":"Rahmayanti","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Brigham and Women's Hospital and Harvard Medical School  Boston 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