Penis reconstruction wi̇th latissimus dorsi muscle-skin flap: Comparison with other techniques through clinical cases

Many methods have been described for penile reconstruction. In particular, free flaps have been considered as the most functional and aesthetically appropriate treatment methods. Many options have been preferred in free flaps. The main purpose of this reconstruction is to create the urinary tract and to provide the most aesthetically similar structure, while providing penile tissue in a size that will ensure adequate sexual intercourse. The chosen reconstruction method should also provide penile rigidity. While bone-containing flaps provide this, a penile prosthesis should be placed in only soft tissue flaps to provide sufficient stiffness. For this reason, the soft tissue should be in the size and quality to carry this prosthesis. This method was questioned through a retrospective analysis of patients who underwent penile reconstruction with the latissimus dorsi free flap, which we think provides all these features. 29 patients who were operated between December 7, 2020 and April 5, 2023 were included in the study group. When the results are evaluated, a tissue in a size that will provide sexual function and a structure in which a penile prosthesis can be easily inserted is obtained in patients who have undergone penile reconstruction with latissimus dorsi. In addition, there is no problem in creating glans penis and corona with this method. Even if we did not create a urethra in our own case series, skin or mucosal grafts will be required due to literature knowledge and clinical experience. However, in this case, the probability of detecting a high rate of urinary fistula or narrowing in the urinary tract is high. In the literature, high rates of complications are mentioned in penile reconstructions performed with other methods. For this reason, it was decided that it would be more appropriate not to make the penile urethra by only lengthening the urethra and to have the urethral opening at the penoscrotal junction. As a result of the retrospective research of our series, we decided that penile reconstruction with Latissimus dorsi, together with some of the modifications described, is one of the most functional and aesthetically appropriate methods. Key words: Latissimus dorsi flap, penile reconstruction, penile prosthesis, free flap, urethra reconstruction