Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series

<i>Background and Objectives:</i> Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies o...

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Main Authors: Gokhan Demirtas, Suleyman Tagcı, Derya Yayla, Hasan Murat Ergani, Gunay Ekberli, Bilge Karabulut, Huseyin Tugrul Tiryaki
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1124
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author Gokhan Demirtas
Suleyman Tagcı
Derya Yayla
Hasan Murat Ergani
Gunay Ekberli
Bilge Karabulut
Huseyin Tugrul Tiryaki
author_facet Gokhan Demirtas
Suleyman Tagcı
Derya Yayla
Hasan Murat Ergani
Gunay Ekberli
Bilge Karabulut
Huseyin Tugrul Tiryaki
author_sort Gokhan Demirtas
collection DOAJ
description <i>Background and Objectives:</i> Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies of penile tissue loss. The continuing growth and the presence of various congenital anomalies in children require a different penile reconstruction approach than in adults. We aimed to share our experience and surgical results with children in whom we performed penile reconstruction with different techniques due to penile tissue loss. <i>Materials and Methods:</i> Ten cases that underwent penile reconstruction between 2018 and 2023 were evaluated retrospectively. Age at initial operation, associated anomalies, surgical technique, and other related surgical attempts, as well as functional and cosmetic results, were recorded. <i>Results:</i> Ten boys aged between 6 months and 17 years underwent phalloplasty due to penile tissue absence. In six cases, penile tissue loss was due to acquired causes, and in four cases, congenital anomalies were the reason. The most common cause of penile tissue loss was circumcision complications. In four cases, penile reconstruction was achieved by mobilization of the remaining corpus cavernosum tissues, in two cases, the cavernous tissue was adequate and repaired with glansplasty and penile skin graft. Phalloplasty was performed by tubularization of a skin and subcutaneous fat flap, removed from the pubic region and scrotal region, in two cases. A microvascular radial forearm flap was performed in a 17-year-old patient with penile tissue loss because of trauma, and a free skin flap taken from the forearm was used for penile reconstruction. Thirty percent of patients required a second surgery. Urinary continence was present in eight of the cases. Although four cases were classified as cosmetically unsatisfactory in our evaluation, all patients and their families reported being satisfied with the cosmetic results. <i>Conclusions:</i> Penile reconstruction for penile tissue loss in children should be performed in clinics where different scenarios can be applied. With maximum preservation and mobilization of existing cavernous tissues, temporary penile reconstruction with local flaps should be performed in young children at an early stage to minimize the psychological effects of penile absence. Although an esthetically perfect result cannot be guaranteed, patients and families are generally satisfied with the outcome.
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spelling doaj-art-829657312f0f477cb890e90992e403a32025-08-20T03:07:55ZengMDPI AGMedicina1010-660X1648-91442025-06-01617112410.3390/medicina61071124Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case SeriesGokhan Demirtas0Suleyman Tagcı1Derya Yayla2Hasan Murat Ergani3Gunay Ekberli4Bilge Karabulut5Huseyin Tugrul Tiryaki6Pediatric Urology Department, Ministry of Health, Sincan Government Hospital, 06930 Ankara, TurkeyPediatric Urology Department, Ankara Bilkent City Hospital, University of Health Science, 06800 Ankara, TurkeyPediatric Urology Department, Gaziantep City Hospital, 27470 Gaziantep, TurkeyPlastic and Reconstructive Surgery Department, Ankara Bilkent City Hospital, University of Health Science, 06800 Ankara, TurkeyPediatric Urology Department, Ankara Bilkent City Hospital, University of Health Science, 06800 Ankara, TurkeyPediatric Urology Department, Ankara Bilkent City Hospital, University of Health Science, 06800 Ankara, TurkeyPediatric Urology Department, Ankara Bilkent City Hospital, University of Health Science, 06800 Ankara, Turkey<i>Background and Objectives:</i> Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies of penile tissue loss. The continuing growth and the presence of various congenital anomalies in children require a different penile reconstruction approach than in adults. We aimed to share our experience and surgical results with children in whom we performed penile reconstruction with different techniques due to penile tissue loss. <i>Materials and Methods:</i> Ten cases that underwent penile reconstruction between 2018 and 2023 were evaluated retrospectively. Age at initial operation, associated anomalies, surgical technique, and other related surgical attempts, as well as functional and cosmetic results, were recorded. <i>Results:</i> Ten boys aged between 6 months and 17 years underwent phalloplasty due to penile tissue absence. In six cases, penile tissue loss was due to acquired causes, and in four cases, congenital anomalies were the reason. The most common cause of penile tissue loss was circumcision complications. In four cases, penile reconstruction was achieved by mobilization of the remaining corpus cavernosum tissues, in two cases, the cavernous tissue was adequate and repaired with glansplasty and penile skin graft. Phalloplasty was performed by tubularization of a skin and subcutaneous fat flap, removed from the pubic region and scrotal region, in two cases. A microvascular radial forearm flap was performed in a 17-year-old patient with penile tissue loss because of trauma, and a free skin flap taken from the forearm was used for penile reconstruction. Thirty percent of patients required a second surgery. Urinary continence was present in eight of the cases. Although four cases were classified as cosmetically unsatisfactory in our evaluation, all patients and their families reported being satisfied with the cosmetic results. <i>Conclusions:</i> Penile reconstruction for penile tissue loss in children should be performed in clinics where different scenarios can be applied. With maximum preservation and mobilization of existing cavernous tissues, temporary penile reconstruction with local flaps should be performed in young children at an early stage to minimize the psychological effects of penile absence. Although an esthetically perfect result cannot be guaranteed, patients and families are generally satisfied with the outcome.https://www.mdpi.com/1648-9144/61/7/1124agenesis of the penisamputationstraumaticreconstructive surgical procedurechildren
spellingShingle Gokhan Demirtas
Suleyman Tagcı
Derya Yayla
Hasan Murat Ergani
Gunay Ekberli
Bilge Karabulut
Huseyin Tugrul Tiryaki
Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
Medicina
agenesis of the penis
amputations
traumatic
reconstructive surgical procedure
children
title Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
title_full Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
title_fullStr Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
title_full_unstemmed Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
title_short Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series
title_sort phalloplasty in children with severe penile tissue loss single center case series
topic agenesis of the penis
amputations
traumatic
reconstructive surgical procedure
children
url https://www.mdpi.com/1648-9144/61/7/1124
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AT deryayayla phalloplastyinchildrenwithseverepeniletissuelosssinglecentercaseseries
AT hasanmuratergani phalloplastyinchildrenwithseverepeniletissuelosssinglecentercaseseries
AT gunayekberli phalloplastyinchildrenwithseverepeniletissuelosssinglecentercaseseries
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