Methods for managing erectile function in cis- And trans-male patients after neophallus reconstruction

Understanding the methods and rationale for managing erectile function in cis- and trans-male patients after neophallus reconstruction is of clinical value to the practicing urologists who encounter such patients. We describe a brief overview of the urologist’s role in the management of sexual function. This communication focuses on pre- and post- construction of a neophallus, considerations for surgical techniques that are largely dependent on whether the patient is cis- or transgender, the traditional method of placing of inflatable penile prosthesis in a neophallus, and in conjunction with the management of complications post implantation. This manuscript is both a review of the current literature in the field, as well as an overview of experience gained from managing a cohort of patients over the years. Additionally, we discuss novel advances that aim to decrease the risk of complications, including distal erosion of the cylinders of the penile prostheses and the proximal dislodgement of cylinders in these unique patients.