454:
753:
loose drape is then deployed over the entire surgical field and secured at the periphery with adhesive strips. A small opening in the drape is then made overlying the incision and yellow hooks utilized to secure the edges of the opening to the edges of the incision, completely covering and isolating the patient's skin. At this point, new instruments and equipment are replaced and the entire prosthesis is inserted through the small opening of the loose drape. The loose drape allows for manipulation of the penis and scrotum required for this procedure without touching the skin.
379:
260:
565:
526:
475:
424:
780:
655:
antibiotic use has been found to be of high importance in the prevention of infection among penile implants. Eid developed the technique in 2006 on the hypothesis that eliminating any contact between the prosthesis and the skin, either directly or indirectly via surgical instruments or gloves, should reduce the incidence of contamination of the device with skin flora responsible for infection.
669:
326:
180:
794:
619:
patients, requiring complete removal of the device and permanent loss of penile size and anatomy. Bacterial contamination of the device can occur during the surgery, and is caused by allowing direct or indirect contact of the prosthesis with the patient's skin. Over 70% of infections occur due to the skin
282:
There are two main types of penile implants – malleable (also known as non-inflatable or semi-rigid) and inflatable implants. Both types have a pair of cylinders implanted into the penis, replacing the non-erectile tissue in cisgender men and serving as the core for the neophallus in the phalloplasty
240:
Temporary lengthening can also be gained by a procedure that releases the suspensory ligament where it is attached to the pubic bone, thereby allowing the penis to be advanced toward the outside of the body. The procedure is performed through a discreet horizontal incision located in the pubic region
756:
Implantation of the device continues with an incision and dilation of corpora, sizing and placing the penile cylinders, and placement of the pump in the scrotum and the reservoir in the retropubic space. Saline is used throughout the implantation for irrigation. Once the corporotomies are closed and
752:
Up until this stage of the surgery, the process has been consistent with the sanitary practices associated with standard surgical sterility. At this stage of the "No-Touch" technique, after the incision has been made, all instruments, including surgical gloves that have touched skin are discarded. A
650:
Traditional strategies to combat infections aim at decreasing skin colony count such as scrubbing skin preparation with alcohol and chlorhexidine or kill bacteria once the implant is contaminated by skin flora such as intravenous antibiotics, antibiotic irrigation and antibiotic-coated implants. The
618:
As advancements in the design and manufacturing process of the IPP improved its mechanical survival, infection has emerged as the leading cause of implant failure. Although relatively infrequent (varying from .06% to 8.9%) infection of a penile prosthesis results in serious medical consequences for
654:
Paired with the antibiotic-coated implant, the "No Touch" technique decreases infection to a rate of 0.46%, opposing the traditional method which has an infection rate of 5%. The use of an antibiotic-coated implant and a no-touch surgical technique with skin preparation measures and peri-operative
1430:
Al-Tamimi, Muhammed; Pigot, Garry L.; van der Sluis, Wouter B.; van de Grift, Tim C.; van
Moorselaar, R. Jeroen A.; Mullender, Margriet G.; Weigert, Romain; Buncamper, Marlon E.; Özer, Müjde; de Haseth, Kristin B.; Djordjevic, Miroslav L. (November 2019).
1383:
Pigot, Garry L.S.; Sigurjónsson, Hannes; Ronkes, Brechje; Al-Tamimi, Muhammed; van der Sluis, Wouter B. (January 2020). "Surgical
Experience and Outcomes of Implantation of the ZSI 100 FtM Malleable Penile Implant in Transgender Men After Phalloplasty".
737:
are administered intravenously one to two hours prior to the procedure. The lower abdomen and genitals are shaved, scrubbed for five minutes with a chlorhexidine sponge and prepped with chorhexidine/alcohol applicator. The area is then draped with a
232:
There are different techniques for phalloplasty. Construction of a new penis (sometimes called a neophallus or neopenis) typically involves taking a tissue flap from a donor site (such as the forearm). Extending the
2062:
by Marc-Olivier Timsit, Pierre
Mouriquand, Alain Ruffion, Alain Bouillot, Diala Dembelé, Arnaud Mejean, Fanny Lalloue, Albert Leriche and Nicolas Morel-Journel (BJU International, Volume 103 Issue 10, Dec
1799:
Eid, J. Francois; Wilson, Steven K.; Cleves, Mario; Salem, Emad A. (2012). "Coated
Implants and "No Touch" Surgical Technique Decreases Risk of Infection in Inflatable Penile Prosthesis Implantation of 0.46%".
1603:
1336:
van der Sluis, Wouter B.; Pigot, Garry L.S.; Al-Tamimi, Muhammed; Ronkes, Brechje L.; de Haseth, Kristin B.; Özer, Müjde; Smit, Jan
Maerten; Buncamper, Marlon E.; Bouman, Mark-Bram (October 2019).
312:
proposes malleable and inflatable penile implants particularly designed for phalloplasty surgeries. Implantation procedures are usually done in a separate surgery to allow time for proper healing.
1870:
Elmussareh, Muhammad; Goddard, Jonathan
Charles; Summerton, Duncan John; Terry, Timothy Robin (2013). "Minimizing the risk of device infection in penile prosthetic surgery: a UK perspective".
1560:
Shirvanian, V.; Lemperle, G.; Araujo Pinto, C.; Elist, J. J. (2014). "Shortened penis post penile prosthesis implantation treated with subcutaneous soft silicone penile implant: case report".
1199:
Carrion, Hernan; Martinez, Daniel; Parker, Justin; Hakky, Tariq; Bickell, Michael; Boyle, Alexander; Weigand, Luke; Carrion, Rafael (July 2016). "A History of the Penile
Implant to 1974".
2133:
100:
Russian surgeon
Nikolaj Bogoraz performed the first reconstruction of a total penis using rib cartilage in a reconstructed phallus made from a tubed abdominal flap in 1936. The first
757:
all of the tubing and components of the prosthesis covered with a layer of Buck's fascia, subcutaneous tissues are closed and the "No-Touch" drape is removed and the skin closed.
308:
in the penis undergoing phalloplasty, and the fact that standard penile implants were designed to be implanted in corpus cavernosum, there were many adverse outcomes. Since 2015,
245:"considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious."
1059:
Morrison, Shane D.; Shakir, Afaaf; Vyas, Krishna S.; Kirby, Johanna; Crane, Curtis N.; Lee, Gordon K. (September 2016). "Phalloplasty: A Review of
Techniques and Outcomes".
2153:
1607:
651:"No-Touch" technique is unique in that it aims to prevent bacterial contamination of the prosthesis by completely eliminating contact of the device with the skin.
2075:
by Albert
Leriche, Marc-Olivier Timsit, Nicolas Morel-Journel, André Bouillot, Diala Dembele and Alain Ruffion (BJU International, Volume 101 Issue 10, Jan 2008)
1939:
Richard Pearcy & Raj Persad, publication date unknown, "Inflatable penile prosthesis," in BJU International Website Atlas of Surgery and Surgical Devices, see
1995:
by Rohrich, Rod J.; Allen, Terry; Lester, Fred; Young, Jonathan P.; Katz, Scott L. (Journal of Plastic and Reconstructive Surgery, Volume 99 Issue 4, April 1997)
2158:
2183:
2022:
2138:
2054:
Long-Term Fate of the Bony Component in Neophallus Construction with Free Osteofasciocutaneous Forearm or Fibula Flap in 18 Female-to-Male Transsexuals
2053:
2047:
2078:
2010:
458:
2050:
by Sengezer, Mustafa; Öztürk, Serdar; Deveci, Mustafa; Odabasi, Zeki (Journal of Plastic and Reconstructive Surgery, Volume 114 Issue 2, August 2004)
2111:
by Rong-Hwang Fang, Yi-Sheng Kaoa, Shiuh Ma, Jin-Teh Lin (Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume 51, Issue 5, July 1998)
1986:
1433:"The Surgical Techniques and Outcomes of Secondary Phalloplasty After Metoidioplasty in Transgender Men: An International, Multi-Center Case Series"
2016:
1998:
1992:
2128:
2081:
by Monstrey, Stan; Hoebeke, Piet; Selvaggi, Gennaro; al etc. (Journal of Plastic and Reconstructive Surgery, Volume 124 Issue 2, August 2009)
2038:
1993:
Simultaneous Penis and Perineum Reconstruction Using a Combined Latissimus Dorsi-Scapular Free Flap with Intraoperative Penile Skin Expansion
1043:
857:
2056:
by Papadopulos, Nikolaos A.; Schaff, Juergen; Biemer, Edgar (Journal of Plastic and Reconstructive Surgery, Volume 109 Issue 3, March 2002)
1656:
1110:
1989:
by Vesely, Jiri; Hyza, Petr; Ranno, Raul; Cigna, Emanuele; Monni, Nicola; al etc. (Annals of Plastic Surgery, Volume 58 Issue 5, May 2007)
2004:
1629:
1952:
1835:
Carson, CC (2004). "Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants".
2163:
807:
2108:
2102:
2084:
2072:
2059:
2025:
by Yang, Mingyong; Zhao, Muxin; Li, Senkai; Li, Yangqun (Journal of Plastic and Reconstructive Surgery, Volume 59 Issue 1, July 2007)
1980:
745:
A 3 cm (1.2 in) scrotal incision is made on the penoscrotal raphe and carried down through the subcutaneous tissue to the
708:
453:
365:
219:
1630:"A Retrospective Evaluation of the Safety and Effectiveness of a Silicone Block Implant for Elective Cosmetic Surgery of the Penis"
1338:"A Retrospective Cohort Study on Surgical Outcomes of Penile Prosthesis Implantation Surgery in Transgender Men After Phalloplasty"
1535:
997:
Schultheiss D, Gabouev AI, Jonas U (2005). "Nikolaj A. Bogoraz (1874-1952): pioneer of phalloplasty and penile implant surgery".
742:
and a Vi Drape over the genitalia. Before the incision is made, a Foley catheter is inserted in the bladder through the urethra.
241:
where the pubic hair will help conceal the incision site. However, scar formation can cause the penis to retract. Therefore, the
1940:
2001:
by Santanelli, Fabio M.D., Ph.D.; Scuderi, Nicolò (Journal of Plastic and Reconstructive Surgery, Volume 105 Issue 6, May 2000)
297:
The pump unit of inflatable penile implants resembles a human testicle and can serve as an artificial testicle for concomitant
287:. Pumping saline into the chambers of this cylinder produces an erection. The glans of the penis, however, remains unaffected.
242:
2048:
Long-Term Follow-Up of Total Penile Reconstruction with Sensate Osteocutaneous Free Fibula Flap in 18 Biological Male Patients
2019:
by Lee, Gordon K.; Lim, Angeline F.; Bird, Erin (Journal of Plastic and Reconstructive Surgery, Volume 124 Issue 1, July 2009)
690:
347:
201:
51:
41:
1987:
New Technique of Total Phalloplasty With Reinnervated Latissimus Dorsi Myocutaneous Free Flap in Female-to-Male Transsexuals
2168:
686:
343:
197:
279:
men. Penile implants have been used in phalloplasty surgeries both in cisgender and transgender patients since 1970s.
1983:
by Sava V. Perovic, Rados Djinovic (British Journal of Urology, Reconstructive Urology, Volume 100 Issue 4, Sep 2007)
725:, a grouping of antibacterial drugs. During this time, the patient scrubs the lower abdomen and genitals daily with
395:
at the base of the neophallus. Nerves from the flap and the tissue it has been attached to may eventually connect.
679:
599:
This phalloplasty procedure involves the insertion of a subcutaneous soft silicone implant under the penile skin.
336:
190:
2178:
827:
625:
309:
291:
158:
101:
749:. A Scott retractor, a flexible device that holds open the skin of the surgical site, is applied to the area.
271:
to achieve an erection. Penile prostheses are implanted devices intended to restore the erectile rigidity in
2090:
510:
305:
873:
2085:
Addressing the ideal requirements by free flap phalloplasty: Some reflections on refinements of technique
1287:"Penile prosthesis implant: scientific advances and technological innovations over the last four decades"
822:
765:
631:
2173:
2031:
Peniplastica Totalis to Reassignment Surgery of the External Genitalia in Female-to-Male Transsexuals
1153:
722:
304:
Initially, standard penile implants were used in phalloplasty procedures. However, since there is no
2017:
A Novel Single-Flap Technique for Total Penile Reconstruction: The Pedicled Anterolateral Thigh Flap
2013:
by Sun, Guang-ci M.D.; Huang, Jin-jing (Annals of Plastic Surgery, Volume 15 Issue 6, December 1985)
1234:
Kang, Audry; Aizen, Joshua M.; Cohen, Andrew J.; Bales, Gregory T.; Pariser, Joseph J. (June 2019).
2105:
by Michael Sohn, and Hartmut Bosinski, MD (Journal of Sexual Medicine, Volume 4 Issue 5, Aug 2007)
1887:
1585:
1517:
1468:
1409:
1365:
1092:
979:
785:
2066:
2007:
by Mutaf, Mehmet (Journal of Plastic and Reconstructive Surgery, Volume 105 Issue 4, April 2000)
1236:"Techniques and considerations of prosthetic surgery after phalloplasty in the transgender male"
1035:
Evidence-Based Trauma Pearls, An Issue of Critical Care Nursing Clinics of North America, E-Book
1118:
847:
378:
2034:
1922:
1852:
1817:
1778:
1761:
Gomelsky, A.; Dmochowski, RR (2003). "Antibiotic prophylaxis in urologic prosthetic surgery".
1743:
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89:
29:
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by Giulio Garaffa, Nim A. Christopher, David J. Ralph (Current Urology, Vol. 3, No. 3, 2009)
2011:
One-Stage Reconstruction of the Penis with Composite Iliac Crest and Lateral Groin Skin Flap
1914:
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615:. Implantation through the use of the "No-Touch" technique minimizes the risk of infection.
611:
implantation is a surgical procedure developed by J. Francois Eid for the implantation of a
1337:
259:
2117:
by Sava V. Perovic, Urologia Polska (Polish Journal of Urology) 2005/58/3, ISSN 0500-7208.
799:
2114:
2099:
by Dan Greenwald and Wayne Stadelmann (eMedicine Journal, Volume 2 Number 7, 6 July 2001)
1999:
Neophalloplasty in Female-to-Male Transsexuals with the Island Tensor Fasciae Latae Flap
1157:
294:, a new penis is formed with the use of a penile implant surrounded with a tissue flap.
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1235:
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1141:
927:
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812:
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612:
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136:
A complete construction or reconstruction of a penis can be performed on patients who:
113:
109:
2073:
Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism
1848:
1142:"Bioengineered corporal tissue for structural and functional restoration of the penis"
564:
525:
474:
423:
2147:
2069:
by Rong-Hwang Fang, Jin-Teh Lin, Shiuh Ma (Microsurgery, Volume 15 Issue 5, Oct 2005)
1690:
1521:
1472:
1413:
1369:
1010:
983:
952:"Modern utilization of penile prosthesis surgery: a national claim registry analysis"
726:
637:
407:
Uses a motor nerve so erogenous sensation cannot be achieved, only tactile sensation.
117:
1953:"A Pioneering Approach to Sex Reassignment Surgery from a World Leader in the Field"
1891:
1589:
1096:
1140:
Chen, Kuo-Liang; Eberli, Daniel; Yoo, James J.; Atala, Anthony (23 February 2010).
298:
125:
1813:
1486:
Hontscharuk, Rayisa; Siotos, Charalampos; Schechter, Loren S. (13 November 2020).
1353:
779:
124:. Gillies' technique remained the standard one for decades. Later improvements in
1072:
2134:
Video: Minimally Invasive Penile Implant Surgery to correct erectile disfunction
2087:
by J. Joris Hage, Floris H. De Graaf (Microsurgery, Volume 14 Issue 9, Oct 2005)
2079:
Penile Reconstruction: Is the Radial Forearm Flap Really the Standard Technique?
1504:
1432:
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325:
276:
179:
149:
81:
1918:
1905:
Muench, Peter J. (2013). "Infections Versus Penile Implants: The War on Bugs".
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1212:
2023:
Penile Reconstruction by the Free Scapular Flap and Malleable Penis Prosthesis
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Glans sculpting in phalloplasty — experiences in female-to-male transsexuals
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It can pull the nipple to the side causing it to be off the usual location.
1573:
967:
392:
283:
procedure. The cylinder of the inflatable implant is filled with sterile
263:
An inflatable penile implant inserted into corpus cavernosum of the penis
63:
693: in this section. Unsourced material may be challenged and removed.
350: in this section. Unsourced material may be challenged and removed.
234:
204: in this section. Unsourced material may be challenged and removed.
85:
34:
237:
through the length of the neophallus is another goal of phalloplasty.
461:
prior to glansplasty penis with tissue grafting scar on the left hip
2067:
Phalloplasty for female transsexuals with sensate free forearm flap
2005:
A New Surgical Procedure for Phallic Reconstruction: Istanbul Flap
452:
377:
2060:
Use of forearm free-flap phalloplasty in bladder exstrophy adults
1981:
Total Phalloplasty Using a Musculocutaneous Latissimus Dorsi Flap
1714:"Current approach to the treatment of penile implant infections"
1536:"Phalloplasty, neophallus, female to male surgery, transgender"
1111:"American Urological Association - Penile Augmentation Surgery"
721:
Three days prior to the procedure, a patient is placed on oral
662:
559:
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469:
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173:
2103:
Gender Identity Disorders: Diagnostic and Surgical Aspects
1794:
1792:
1657:"Penis Implants Exist Now, and They Start at a Size Large"
2115:
Severe Penile Injuries: Etiology, Management and Outcomes
2091:
Total Phallic Construction in Female to Male Transsexuals
575:
536:
485:
434:
382:
Hip showing scar from skin graft used for phalloplasty.
50:
40:
28:
23:
849:Ferri's Clinical Advisor 2021 E-Book: 5 Books in 1
2129:FemaletoMale.org | Information about Phalloplasty
88:. The term is also occasionally used to refer to
1677:Eid, J. Francois (2011). "No-Touch Technique".
1672:
1670:
1146:Proceedings of the National Academy of Sciences
84:or the artificial modification of the penis by
1488:"Strategies for innervation of the neophallus"
1032:Vaughan, Jeanette; Villegas, Whitney (2023).
275:men and to build a neophallus (new penis) in
80:) is the construction or reconstruction of a
18:Operation to construct or reconstruct a penis
8:
1562:International Journal of Impotence Research
2154:Gender-affirming surgery (female-to-male)
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1312:
1302:
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1165:
1038:. Elsevier Health Sciences. p. 182.
926:
916:
901:"Phalloplasty: The dream and the reality"
852:. Elsevier Health Sciences. p. 594.
768:could also become a standardized method.
709:Learn how and when to remove this message
366:Learn how and when to remove this message
220:Learn how and when to remove this message
1604:"Shortened penis post penile prosthesis"
950:Segal RL, Camper SB, Burnett AL (2014).
258:
838:
20:
1425:
1423:
7:
691:adding citations to reliable sources
607:The no-touch surgical technique for
348:adding citations to reliable sources
202:adding citations to reliable sources
2159:Genital modification and mutilation
1655:Hannah Smothers (27 January 2016).
1291:Translational Andrology and Urology
1240:Translational Andrology and Urology
267:Phalloplasty requires an implanted
59:
2184:Surgical procedures and techniques
1061:Plastic and Reconstructive Surgery
808:List of transgender-related topics
595:Subcutaneous soft silicone implant
391:Sensation is retained through the
140:Have congenital anomalies such as
14:
1849:10.1097/01.ju.0000118245.66976.e1
729:soap. On the day of the surgery,
509:This phalloplasty method is from
170:Techniques and related procedures
1691:10.1111/j.1743-6109.2010.02137.x
1011:10.1111/j.1743-6109.2005.20114.x
792:
778:
667:
563:
524:
473:
422:
324:
178:
128:made more techniques available.
1718:Therapeutic Advances in Urology
678:needs additional citations for
459:female-to-male sex reassignment
399:Flap from the side of the chest
335:needs additional citations for
243:American Urological Association
189:needs additional citations for
1492:Plastic and Aesthetic Research
1437:The Journal of Sexual Medicine
1386:The Journal of Sexual Medicine
1:
1814:10.1016/j.urology.2011.11.076
1763:Current Pharmaceutical Design
1354:10.1016/j.urology.2019.06.010
1285:Chung, Eric (February 2017).
505:Latissimus dorsi phalloplasty
108:was performed in 1946 by Sir
1073:10.1097/PRS.0000000000002518
899:Rashid M, Tamimy MS (2013).
623:'s microorganisms including
1872:Journal of Clinical Urology
1632:. SMSNA.org. Archived from
1505:10.20517/2347-9264.2020.124
603:No-touch surgical technique
403:The disadvantages include:
2200:
1919:10.1016/j.juro.2012.05.080
1449:10.1016/j.jsxm.2019.07.027
1398:10.1016/j.jsxm.2019.09.019
1213:10.1016/j.sxmr.2016.05.003
292:sex reassignment surgeries
252:
2164:Male genital modification
1712:Mulcahy, John J. (2010).
316:Explanation of techniques
60:
1884:10.1177/2051415813488367
1775:10.2174/1381612033455198
1730:10.1177/1756287210370330
1606:. MDLinx. Archived from
1540:Genital Surgery Belgrade
918:10.4103/0970-0358.118606
828:Sex reassignment surgery
626:Staphylococcus epidermis
310:Zephyr Surgical Implants
159:gender-affirming surgery
102:gender-affirming surgery
2033:. VU University Press.
2029:Hage, J. Joris (1992).
1304:10.21037/tau.2016.12.06
1253:10.21037/tau.2019.06.02
1201:Sexual Medicine Reviews
1167:10.1073/pnas.0909367106
846:Ferri, Fred F. (2020).
513:musculocutaneous flap.
1957:reports.mountsinai.org
1942:, accessed 31 May 2014
572:This section is empty.
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482:This section is empty.
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431:This section is empty.
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122:The First Man-Made Man
878:The Aesthetic Society
823:Penis transplantation
766:Penis transplantation
632:Staphylococcus aureus
456:
381:
262:
154:Have lost their penis
2169:Male genital surgery
1574:10.1038/ijir.2013.44
968:10.1038/ijir.2014.11
687:improve this article
344:improve this article
198:improve this article
112:on fellow physician
1158:2010PNAS..107.3346C
905:Indian J Plast Surg
874:"Penis Enlargement"
457:Example of stage 1
2139:No-touch technique
2097:Gender Reassigment
1907:Journal of Urology
786:Transgender portal
463:
384:
265:
2040:978-90-5383-115-1
1443:(11): 1849–1859.
1045:978-0-32393-934-8
859:978-0-32371-334-4
818:Penis enlargement
719:
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609:penile prosthesis
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517:Gillies technique
502:
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415:Flap from the leg
387:Flap from the arm
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306:corpus cavernosum
269:penile prosthesis
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163:gender transition
161:as part of their
90:penis enlargement
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1152:(8): 3346–3350.
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1117:. Archived from
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191:verification
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126:microsurgery
121:
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74:Phalloplasty
73:
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2174:Human penis
1640:18 February
1614:16 February
1348:: 195–201.
277:transgender
150:hypospadias
132:Indications
2148:Categories
1685:(1): 5–8.
834:References
735:gentamicin
731:vancomycin
621:microbiome
146:epispadias
142:micropenis
78:penoplasty
42:ICD-10-PCS
1679:J Sex Med
1522:228915526
1514:2347-9264
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1457:1743-6095
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699:June 2014
659:Procedure
273:cisgender
106:trans man
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937:24501465
884:11 March
772:See also
356:May 2020
210:May 2020
120:'s book
1974:Sources
1802:Urology
1739:3126071
1342:Urology
1314:5313299
1263:6626310
1177:2840474
1154:Bibcode
928:3901910
235:urethra
157:Desire
96:History
86:surgery
35:Urology
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