Radial Artery Phalloplasty

Radial Artery Phalloplasty surgery is a complex staged operation in which a phallus is created from the forearm. The 1st stage is creation of the phallus. The length of hospital stay is usually 7-10days. There are 3 areas where you will have significant wounds:

1. The forearm: The phallus is created using a large flap of skin from the forearm. The deficit on the arm created by removing the flap is covered by a full thickness graft harvested from the buttocks. The graft is inspected one week after surgery. The graft site will then be redressed before you are discharged home and then by your district/practice nurse regularly until it is fully healed.
2. Buttock donor site: The grafts for the forearm are taken from the buttocks. The wounds are closed with staples, stitches or sometimes both. The staples/ stitches are removed 2 weeks following the surgery by your district/practice nurse. The buttocks will feel tight, and it is advisable to sit on your coccyx (tail bone) whilst they are healing.
3. Phallus: The phallus has been created using the flap from the forearm. A urethra (water- pipe) is created at the same time. The new urethra will either be joined to your native urethra during this operation or will be attached at the next stage of your reconstructive surgery. Your surgeon will advise you at which stage your urethral join-up will take place.

For three weeks after surgery, it is important to keep your phallus at an angle of 45 degrees to facilitate blood flow to the tissues. If you develop any grey or black areas on your phallus, please do not hesitate in contacting the surgical team via the Clinical Nurse Practitioners or call UCLH Switchboard on 02034567890 and ask to be put through to Urology ward 3rd Floor, Westmoreland Street.

If you’ve had urethral join up of your native urethra to the new urethra, you will receive a date to attend our x-ray department 3-4 weeks after the surgery for a urethrogram which is a study to establish if the ‘join-up’ wound has healed. You will then be seen in clinic and a decision will be made as to whether the catheter can be removed or if it needs to be kept in place for 2-3 weeks longer.

Dressings: You will be referred to either District or Practice Nurse to regularly review and redress your wounds.

Arm: Your hand may be swollen for a few weeks, and we would therefore recommend you keep it elevated until it settles. To minimise the risk of the graft lifting we advise you not to straighten your arm for two weeks after the surgery and not to bend your wrist for three weeks following surgery. After three weeks you can move your arm and wrist freely.

Bleeding: If there is slight ooze of blood from the wounds, it can usually be stopped by applying pressure to the area using a clean piece of gauze to press firmly onto the area for about 10mins. If bleeding does not stop, seek medical advice.

Pain: Please take your painkillers regularly as prescribed. Do not exceed the stated dose. Discomfort/ pain will improve over time but may take a few weeks to disappear.

Returning to work: We recommend at least 4 weeks off work. If your job is physically demanding, a phased return to work may be appropriate. If you require a sick certificate, please ask the medical team before you leave hospital.

Follow up appointment: You will be asked to attend clinic for review 3-4 weeks after the surgery and if you require a urethrogram we will do our best to co-ordinate this for the same day

If you experience any of the following, please contact the Clinical Nurse Practitioner or your medical team via the numbers overleaf. Out of hours, please contact your GP or nearest Accident & Emergency Department

• Persistent bleeding
• Pain which is not controlled by the prescribed pain killers
• A fever of 100 (38 C) or higher
• You have redness and or discharge from the wound

Pathway Co-ordinator to Consultants
Telephone: 020 3447 9190 / 020 3447 9280

Clinical Nurse Practitioners (CNP)
Mobile: 07852168167 / 07929710288

Email: uclh.enquiry.andrology@nhs.net

NHS 111
Website: https://111.nhs.uk
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