<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000300110</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Reconstrucción peniana mediante microcirugía en Costa Rica]]></article-title>
<article-title xml:lang="en"><![CDATA[Penile reconstruction with microsurgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Centeno-Ramírez]]></surname>
<given-names><![CDATA[Carlos Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Centeno-Rodríguez]]></surname>
<given-names><![CDATA[Madelein]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital México Servicio de Cirugía Plástica, Reconstructiva y Microcirugía ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital San Juan de Dios Servicio de Cirugía Plástica, Reconstructiva y Microcirugía ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>3</numero>
<fpage>110</fpage>
<lpage>112</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000300110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000300110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000300110&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El pene tradicionalmente se ha considerado un símbolo de poder, masculinidad y fertilidad, por lo cual toda patología peniana congénita o adquirida, que eventualmente culmine en la amputación parcial o total del falo, constituye un evento catastrófico para cualquier hombre, presentando efectos devastadores, tanto físicos como psicológicos. Los diferentes niveles de amputación peniana en un individuo pueden definir su capacidad de miccionar y de concretar el coito, lo que perjudica directamente su virilidad y desempeño sexual y, por ende, su bienestar psicológico. Todo esto justifica el esfuerzo reconstructivo que se pueda ofrecer con el fin de mejorar la calidad de vida del paciente. El colgajo libre radial de antebrazo se ha considerado por muchos años el estándar de oro en reconstrucción peniana, ya que ha demostrado buenos resultados funcionales y estéticos. Esta técnica microquirúrgica representa un gran avance reconstructivo, lo cual se traduce en un rescate de la autoestima y de la masculinidad del paciente, con mejoría significativa de su calidad de vida. A continuación se presenta el caso clínico de un paciente masculino de 35 años de edad, quien requirió una amputación casi total de pene, secundaria a una quemadura eléctrica severa, y posteriormente fue sometido a la primera reconstrucción peniana microquirúrgica con colgajo libre radial de antebrazo, en Costa Rica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The penis has traditionally been considered a symbol of power, masculinity and fertility, so any congenital or acquired penile pathology that eventually culminates in partial or total amputation of the phallus constitutes a catastrophic event for any man, presenting both physical and psychological devastating effects. The different levels of penile amputation in an individual can define their ability to micturate and to concretize sexual intercourse, which directly impairs their virility and sexual performance and thus their psychological well-being. All this finally justifies any reconstructive effort that can be offered in order to improve the patient&#8217;s quality of life. The free radial forearm flap has been considered for many years the gold standard in penile reconstruction as it has demonstrated good functional and aesthetic results. This microsurgical technique represents a great reconstructive advance, which results in a rescue of the patient&#8217;s self-esteem and masculinity with a significant improvement in his quality of life. The authors present the clinical case of a 35-year-old male patient who required an almost total amputation of the penis, secondary to a severe electrical burn and who subsequently underwent the first microsurgical penile reconstruction with a free radial forearm flap in Costa Rica.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[pene]]></kwd>
<kwd lng="es"><![CDATA[reconstrucción]]></kwd>
<kwd lng="es"><![CDATA[microcirugía]]></kwd>
<kwd lng="es"><![CDATA[colgajos tisulares libres]]></kwd>
<kwd lng="en"><![CDATA[Penis]]></kwd>
<kwd lng="en"><![CDATA[reconstruction]]></kwd>
<kwd lng="en"><![CDATA[microsurgery]]></kwd>
<kwd lng="en"><![CDATA[free tissue flaps]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monstrey]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ceulemans]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Roche]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Houtmeyers]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lumen]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Hoebeke]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstruction of male genital defects]]></article-title>
<source><![CDATA[Neligan PC, ed. Plastic Surgery]]></source>
<year>2013</year>
<edition>3</edition>
<page-range>297-325</page-range><publisher-loc><![CDATA[China ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gilbert]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Jordan]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstruction of male genital defects: congenital and acquired]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Mathes]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Plastic Surgery]]></source>
<year>2006</year>
<page-range>1197-258</page-range><publisher-loc><![CDATA[China ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Salgado]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Chim]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Monstrey]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mardini]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Penile reconstruction]]></article-title>
<source><![CDATA[Semin Plast Surg]]></source>
<year>2011</year>
<volume>25</volume>
<page-range>221-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Herman]]></surname>
<given-names><![CDATA[CK]]></given-names>
</name>
<name>
<surname><![CDATA[Hoschander]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Strauch]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radial Forearm free flap for penile reconstruction]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Strauch]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Vasconez]]></surname>
<given-names><![CDATA[LO]]></given-names>
</name>
<name>
<surname><![CDATA[Hall-Findlay]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
</person-group>
<source><![CDATA[Grabb´s encyclopedia of flaps]]></source>
<year>2009</year>
<edition>3</edition>
<page-range>1241-59</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Lippincott Williams &amp; Wilkins]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monstrey]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hoebeke]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Selvaggi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ceulemans]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Van Landuyt]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Blondeel]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Penile reconstruction: is the radial forearm flap really the standard technique?]]></article-title>
<source><![CDATA[Plast Reconstr Surg]]></source>
<year>2009</year>
<volume>124</volume>
<page-range>510-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Massanyi]]></surname>
<given-names><![CDATA[EZ]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Goel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gearhart]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Burtett]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Bivalacqua]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Redett]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radial forearm free flap phalloplasty for penile inadequacy in patients with exstrophy]]></article-title>
<source><![CDATA[J Urol]]></source>
<year>2013</year>
<volume>190</volume>
<numero>^s4</numero>
<issue>^s4</issue>
<supplement>4</supplement>
<page-range>1577-82</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bluebond-Langner]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Redett]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Phalloplasty in complete aphallia and ambiguous genitalia]]></article-title>
<source><![CDATA[Semin Plast Surg]]></source>
<year>2011</year>
<volume>25</volume>
<page-range>196-205</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Perovic]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Phalloplasty in children and adolescents using the extended pedicle island groin flap]]></article-title>
<source><![CDATA[J Urol]]></source>
<year>1995</year>
<volume>154</volume>
<page-range>848-53</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sengezer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Öztürk]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Deveci]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Odabasi]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term follow-up of total penile reconstruction with sensate osteocutaneous free fibula flap in 18 biological male patients]]></article-title>
<source><![CDATA[Plast Reconstr Surg]]></source>
<year>2004</year>
<volume>114</volume>
<page-range>439-50</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Djordjevic]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Bumbasirevic]]></surname>
<given-names><![CDATA[MZ]]></given-names>
</name>
<name>
<surname><![CDATA[Vukovic]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Sansalone]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Perovic]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children]]></article-title>
<source><![CDATA[J Pediatr Urol]]></source>
<year>2006</year>
<volume>2</volume>
<page-range>333-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Soutar]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Colgajo radial del antebrazo]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Wei]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Mardini]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Colgajos en cirugía reparadora]]></source>
<year>2009</year>
<page-range>321-38</page-range><publisher-loc><![CDATA[Barcelona, España ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lumen]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Monstrey]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ceulemans]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[van Laecke Ey Hoebeke]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstructive surgery for severe penile inadequacy: phalloplasty with a free radial forearm flap or a pedicled anterolateral thigh flap]]></article-title>
<source><![CDATA[Adv Urol]]></source>
<year>2008</year>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The forearm flap]]></article-title>
<source><![CDATA[Clin Plast Surg]]></source>
<year>1982</year>
<volume>9</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>21-6</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
<name>
<surname><![CDATA[Hwang]]></surname>
<given-names><![CDATA[WY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Forearm flap in one-stage reconstruction of the penis]]></article-title>
<source><![CDATA[Plast Reconstr Surg]]></source>
<year>1984</year>
<volume>74</volume>
<page-range>251-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martín Díaz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez López]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Romero Otero]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz Gutiérrez]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Cabezón Hedo]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[García Martínez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Faloplastía mediante colgajo libre microquirúrgico antebraquial radial con doble tunelización. A propósito de un caso]]></article-title>
<source><![CDATA[Cir Plást Iberolatinoam]]></source>
<year>2011</year>
<volume>37</volume>
<page-range>137-42</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
