MLD = Musculocutaneous Latissimus Dorsi Flap Phalloplasty
Musculocutaneous Latissimus Dorsi (MLD) Flap Phalloplasty uses part of a back muscle and includes the thoracodorsal vessels and nerve. The blood supply is connected to the femoral artery and saphenous vein or the deep inferior epigastric artery and vein, while the nerve is connected to the ilioinguinal nerve.
Urethroplasty is usually done in two stages – primary urethral lengthening and secondary urethral lengthening. Some surgeons will incorporate a buccal mucosa graft.
Sizes vary between 13 to 16cm in length and 10 to 12cm in girth. A penile implant is possible in stage 4.
The scar is easily concealed, forming a long, mostly linear scar that runs from under the arm, slightly curved down to the lower back. There is low donor site morbidity and due to the relatively hairless donor site, the aesthetic outcomes are pleasing.
The patient is able to urinate standing and provided a penile implant is inserted, sexual intercourse is possible. Due to innervation via a motorized nerve however, erotic sensations are less than can be expected through RFF phalloplasty, although typically better than the achievement through abdominal and groin flap phalloplasty.
ZSI is the only European manufacturer of artificial urinary sphincters and of malleable and inflatable penile implants, as solutions for male urological problems (incontinence), sexual complications (Erectile Dysfunction), and gender identity procedures (prostheses for trans men and women).
