{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:59:29Z","timestamp":1770454769338,"version":"3.49.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":1001,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T00:00:00Z","timestamp":1563148800000},"content-version":"tdm","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Hypospadias is a congenital malformation of the male genitalia. The reconstructive objectives are to obtain voiding with laminar flow and satisfactory sexual function. Several urethroplasty techniques have been described, but for perineal or revisional cases no single technique has shown robust success. In this study, we describe the expanded use of intestinal flaps for urethral reconstruction and report a peculiar request from a patient to undergo peno-urethral separation after successful hypospadias repair with a free ileum flap. A 51-year-old male patient with perineal hypospadias underwent several urethral reconstructive procedures with poor outcomes. A free ileum flap was attempted as a substitute for the urethra. Following successful reconstruction, separation of the neo-urethra (ileum) from the penile body was performed to address the patient\u2019s sexual expectations. A free ileum flap proved to be a reliable urethral substitute in perineal hypospadias reconstruction, with a successful outcome. The peno-urethral separation with the creation of an \u201caccessory penis,\u201d however peculiar, optimized the results in terms of both sexual and urinary function. Anatomical restoration of the urethra and patient-reported expectations are the key to successful hypospadias reconstructive procedures. Sexual function outcomes and the patient\u2019s perception of success should not be underestimated, even when urinary function has been restored.<\/jats:p>","DOI":"10.5999\/aps.2018.00689","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T01:00:47Z","timestamp":1563498047000},"page":"381-385","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Accessory penis: A rare method of peno-urethral separation of sexual function and voiding following successful complex hypospadias reconstruction with a free ileum flap"],"prefix":"10.1055","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6094-5159","authenticated-orcid":false,"given":"Rossella","family":"Elia","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-277X","authenticated-orcid":false,"given":"Georgios","family":"Pafitanis","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Group for Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Ciudad","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, China Medical University 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