{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:30:12Z","timestamp":1730871012313,"version":"3.28.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation. The indication for a double flap phalloplasty was posed as only way to fully reconstruct the urethra on its length avoiding possible complications of single flap reconstruction using tube-into-tube technique. Both flaps healed uneventfully with no neourethral strictures or fistulas described. At 18 months follow-up, the patient was extremely satisfied with the aesthetic result and was able to void in standing position. We think that a double free tissue transfer for TPR should be considered, particularly when a urethral length\u2009&gt;\u200914\u2009cm needs to be reconstructed. While the pedicled ALT can be used to reconstruct a proper penile shaft with an easily concealed scar, the RFFF can provide adequate neourethra length with satisfactory sensory recovery at the neoglans.<\/jats:p>","DOI":"10.1055\/s-0042-1748662","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T22:30:16Z","timestamp":1653690616000},"page":"448-452","source":"Crossref","is-referenced-by-count":0,"title":["Total Urethra and Penile Shaft Reconstruction with Combined Pedicled Anterolateral Thigh Flap and Radial Forearm Free Flap after Total Penectomy"],"prefix":"10.1055","volume":"49","author":[{"given":"Pietro Giovanni","family":"di Summa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Sapino","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Bauquis","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"issue":"39","key":"ref1","first-page":"646","article-title":"The diagnosis and treatment of penile cancer","volume":"115","author":"O W Hakenberg","year":"2018","journal-title":"Dtsch Arztebl 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total phalloplasty: the mushroom flap","volume":"72","author":"S D Morrison","year":"2014","journal-title":"Ann Plast Surg"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1055\/s-0034-1369807","article-title":"A new plane of elevation: the superficial fascial plane for perforator flap elevation","volume":"30","author":"J P Hong","year":"2014","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.cps.2016.08.004","article-title":"Pre-expanded anterolateral thigh perforator flap for phalloplasty","volume":"44","author":"S D'Arpa","year":"2017","journal-title":"Clin Plast Surg"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1155\/2008\/704343","article-title":"Reconstructive surgery for severe penile inadequacy: phalloplasty with a free radial forearm flap or a pedicled anterolateral thigh flap","author":"N Lumen","year":"2008","journal-title":"Adv Urol"},{"issue":"08","key":"ref12","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1002\/micr.30190","article-title":"Double flap phalloplasty in transgender men: Surgical technique and outcome of pedicled anterolateral thigh flap phalloplasty combined with radial forearm free flap urethral reconstruction","volume":"37","author":"W B van der Sluis","year":"2017","journal-title":"Microsurgery"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1111\/j.1464-410X.2009.08424.x","article-title":"Total phallic reconstruction after penile amputation for carcinoma","volume":"104","author":"G Garaffa","year":"2009","journal-title":"BJU Int"}],"container-title":["Archives of Plastic 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