American Society for Peripheral Nerve

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Genital Sensibility in the Neophallus: Getting a Sense of the Current Literature
Shane D Morrison, MD1; Rachel Bluebond-Langner, MD2; Jens U Berli, MD3; Jonathan Massie, MD4; A. Lee Dellon, MD, PhD5
1University of Washington, Seattle, WA; 2NYU Langone, New York, NY; 3Oregon Health and Science University, Portland, OR; 4Northwestern, Chicago, IL; 5Johns Hopkins University, Towson, MD


Phalloplasty surgery attempts to achieve a functional and aesthetic realistic phallus. Sensation is a key component of a functional phallus due the importance for sexual pleasure and protective function in case of implant insertion.. Little data is currently available on genital sensibility outcomes after phalloplasty, and there are no standardized approaches for assessment.


A literature search of PubMed, Google Scholar, and MEDLINE databases was conducted with medical subject heading terms related to genital sensibility after phalloplasty. Data on patient demographics, nerves used for coaptation, and measurements of genital sensibility were collected. Pooled event rates were determined for recovered glans sensibility and recovered erogenous sensation using a Freeman-Tukey Arcsine transformation.


A total of 341 papers were identified of which 26 met the inclusion criteria for final analysis. The dorsal cutaneous branch of the pudendal nerve and ilioinguinal were the most common donor nerves. The lateral and medial antebrachial cutaneous and lateral femoral cutaneous were the most common recipient nerves. Pooled event rates suggest that recovered glans sensibility occurs in over 70% of cismale patients and in over 90% of transmale patients. Recovered erogenous sensation occurs in over 75% of cismale patients and over 95% of transmale patients. In cismale patients, outcomes of recovered glans sensibility and erogenous sensation may be better for upper extremity recipient nerves than lower extremity recipient nerves.


Based on the very limited data available in current literature on genital sensibility after phalloplasty, it is difficult to draw evidence-based conclusions. Yet data support improved outcomes with innervation during phalloplasty. Standardized collection and assessment protocols are needed

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