Is there any way to get urethral lengthening/pee standing with abdominal/pubic phalloplasty WITHOUT using the arm at all? I would really like to leave my arm untouched, which is one of the main reasons I'm choosing abdominal/pubic phalloplasty, but according to the staging chart on phallo.net (which is how I got to this forum) the only way to do this would be to use the radial artery. Is there any hope of achieving this without it? I've heard vaginal, labia, and mouth tissue could be used for the urethra, why is this not shown as an option anywhere?

Great question! The staging chart you referenced is from the London team and they use a strip from the forearm to create the urethra in Abdominal Phalloplasty. The radial forearm flap is used for the urethra because it's vascularized. Non-vascularized urethroplasty, for example using a buccal mucosa graft, has a higher rate of fistula and stricture, approaching 50%. Dr. Kim in South Korea does a groin flap Phalloplasty with the urethra constructed with vaginal mucosa. Surgeons in Finland have reported creating the phallus with gracilis flaps and creating the urethra from a groin flap. Abdominal Phalloplasty with UL isn't commonly performed in the US, I assume because surgeons would prefer to use vascularized tissue to reduce complications.

Great question! The staging chart you referenced is from the London team and they use a strip from the forearm to create the urethra in Abdominal Phalloplasty. The radial forearm flap is used for the urethra because it's vascularized. Non-vascularized urethroplasty, for example using a buccal mucosa graft, has a higher rate of fistula and stricture, approaching 50%. Dr. Kim in South Korea does a groin flap Phalloplasty with the urethra constructed with vaginal mucosa. Surgeons in Finland have reported creating the phallus with gracilis flaps and creating the urethra from a groin flap. Abdominal Phalloplasty with UL isn't commonly performed in the US, I assume because surgeons would prefer to use vascularized tissue to reduce complications.

Thank you so much for your very comprehensive reply, this will be of a lot of help when discussing options with my surgeons, I would very much prefer having the UL done with vaginal or groin tissue than using the arm, I would rather risk some complications (which as far as I understand, can usually be fixed if needed). Again thank you so much!