In this episode of The Resident Review, we’re joined by Dr. Jens Berli, a gender-affirming microsurgeon from OHSU in Portland, Oregon. We discuss his approach to phalloplasty, with special attention on preoperative workup, with an emphasis on interdisciplinary care. We discuss pros and cons of different donor sites (thigh vs forerarm) and aspects of his microvascular anastomotic work. Each patient represents a unique case with their goals for embodiment, but we walk through the perioperative workup of an example patient, from preop consult to free tissue transfer, urethroplasty and more. Dr. Berli also shares recommendations on how medical students and residents interested in phalloplasty can learn more about these procedures.
If not familiar with the technical steps of phalloplasty, listeners are suggested to watch their team’s 12-minute video, available open-access at PRS Global Open.
Peters, Sajadi, Berli. “Big Ben Method Phalloplasty: Step by Step.” PRSgo. 2023. 11(7):e5126.
https://pubmed.ncbi.nlm.nih.gov/37465284/
The podcast also discusses metoidioplasty, which is sometimes done prior to phalloplasty. An understanding of meta can be helpful to conceptualize aspects of phallo (e.g. vaginectomy). Link below is from Dr. Berli’s urology partners – may require access through your academic institution: (two videos, 14 minutes total).
Lin-Brande et al. “Metoidioplasty With Urethral Lengthening: A Stepwise Approach.” Urology. 2021. 147:319-322. https://pubmed.ncbi.nlm.nih.gov/32971121/
OHSU Phalloplasty Patient Guide:
https://www.ohsu.edu/sites/default/files/2022-07/OHSU-phalloplasty_booklet-2022.pdf
OHSU Phalloplasty Nerve Rehab Guide
https://www.ohsu.edu/sites/default/files/2022-07/THP-phalloplasty-nerve-rehab-guide-2022.pdf
