Prosthetic Considerations in Neophallic Reconstruction

Purpose of Review: Phalloplasty may be performed in patients with acquired or congenital penile insufficiency or transgender individuals who desire phallic construction. Demand for neophallus creation and prosthesis placement has increased in recent years with growing coverage for gender affirming surgery among transgender patients. This report describes consideration of prosthetic implantation in neophallic reconstruction. Recent Findings: Prosthesis implantation in a neophallus requires special consideration regarding avoidance of critical structures, proximal prosthesis anchoring, and distal cushioning in patients without native corpora cavernosa. Neophallus prostheses are associated with increased risk of infection, extrusion, erosion, and device migration relative to standard prostheses, with a high revision rate. Summary: Implanters should have a thorough understanding of neophallic reconstructive technique prior to proceeding with device placement. Current literature on this subject consists predominantly of retrospective reviews and case reports with variable outcome measures. The creation of validated assessment tools will provide more meaningful data to inform provider counseling and patient expectations.