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What is the outcome of a phalloplasty?

In the absence of the ideal technique each patient needs to make an informed choice of the procedure which best meets their individual requirements.  This inevitably requires a degree of compromise.  The radial artery phalloplasty gives the best results in terms of urinary function but is an extremely traumatic procedure with long-term damage to the donor arm.  The scars from the pubic phalloplasty are far less conspicuous and the procedure itself involves shorter stays in hospital though generally more of them and spread out over a longer period of time.

Standing to urinate should be possible with the pubic phalloplasty by using the RAU technique.  If standing to urinate is the only consideration then a metoidioplasty may be the preferred option but our experience is that 25% of patients return later requiring a cosmetically acceptable phallus and/or sexual function.  Sensation is often possible with the radial artery phalloplasty but should not be expected in the pubic phalloplasty. Whether a patient opts for the pubic phalloplasty or the radial artery phalloplasty he can expect to end up with a cosmetically acceptable phallus suitable for penetrative sexual intercourse.

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