Coloplast Titan fill volumes (for both cylinders). Volume is halved for single cylinder use in phalloplasty.

14 cm 40cc
16 cm 50cc
18 cm 60cc
20 cm 70cc
22 cm 90cc
24 cm 110cc
26 cm 120cc

Nomenclature: Johanson Urethroplasty

- derives from Swedish urologist Bror Johanson, who described the original two-stage urethroplasty for urethral strictures
- common mispelling: Johansson, Johansen, Johannson

Ring Metoidioplasty: Outcomes & Technical Analysis

Technique:
- Labia minora ring flap for UL
- Ghent method for scrotoplasty
➡️ 94 pts (44m follow-up)
➡️ 14% fistulas (6 repaired), 4% strictures
➡️ 9% urethral revision rate | <5% scrotal necrosis

ovid.com/jnls/ijoru/ful…

Pedicled Labia Minora Flap for Urethral Lengthening in Phalloplasty

➔ 16 patients (ALT/SCIP)
➔ Fistula 25%, Stricture 37.5%, Perineal urethrostomy 18.7%
➔ Standing voiding: 56.3%

Feasible but high stricture/fistula rates
DOI: 10.1016/j.urology.2019.10.041

Anterolateral Thigh Phalloplasty With Staged Skin Graft Urethroplasty

→ 24 patients, 3-stage ALT phalloplasty
→ Standing micturition achieved: 87.5%
→ Urologic complications: fistula 33.3%, stricture 20.8%
→ Staged STSG urethroplasty offers a viable path to standing micturition with manageable revisions.
DOI: 10.1016/j.urology.2023.03.038

Long-term outcomes for primary IPP insertion after phalloplasty (London 2026)

N=694; 9/2001 to 7/2024
▶️RF phallus 506/694
▶️Infection: 69/694
▶️Mech fail: Boston 30%, Coloplast 12%
▶️Overall revision: 40% 5 yrs; 56% 10yrs; 65% 15yrs
bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bj…

Perioperative Antimicrobial Strategies in Inflatable Penile Prosthesis Surgery

Multicenter retrospective study 5261 patients
▶️Infection rate 1.9%
▶️Antifungal use lowers risk
▶️Postop abx > 24 hrs no benefit
⏩Use antifungal; question postop abx > 24 hrs
pubmed.ncbi.nlm.nih.gov/40779661/

Multicenter Analysis of Long-Term Outcomes of AUS After Urethroplasty

▶️178 patients (17 surgeons)
▶️Complications: explant, erosion, infection, atrophy, mech failure
▶️Prior transecting Uplasty 56% | nontransecting 24%
⏩AUS risk higher in patients who had transecting urethroplasty

auajournals.org/doi/10.1097/JU…

Rates of infection of hydrophilic IPPs (inflatable penile prostheses) using 0.05% CHG (chlorhexidine gluconate)

▶️14 institutions, 2150 IPPs
▶️Infections: CHG 4.6%, Abx 2.1%
⏩CHG use increases infection risk of hydrophilic IPPs
pubmed.ncbi.nlm.nih.gov/41264801/

ZSI475 (IPP) and ZSI100 (MPP) outcomes (Amsterdam 2025)

▶️50 patients, 85 implants (66 IPPs; 19 MPPs)
▶️Median followup 26mos IPPs, 32mos MPPs
▶️Infection: IPP 15%, MPP 11%
▶️Revision 56%
⏩Poor 3-yr complication free survival: 39% IPPs and 31% MPPs
pubmed.ncbi.nlm.nih.gov/40898602/

London Staging of RFFF phalloplasty:

▶️ Stage 1: RFFF phallus, pars pendulans (PP) from RFFF matured to labial skin after resection of minora projection
▶️Stage 2: pars fixa (PF) from vaginal + labial flaps | PF-PP anastomosis | glansplasty | scrotoplasty | vaginectomy

London Staged RFFF phalloplasty urethral outcomes 2010

▶️ N = 115: 3 phallus loss | 84 PF and PP urethroplasty |
▶️31 PP urethroplasty only
▶️Median followup 26 months (1998-2008)
▶️Fistulas 20
▶️Strictures 9
⏩Revisions 29/84 (35%)
pubmed.ncbi.nlm.nih.gov/19477578/