Mr Giulio Garaffa

Tel: 0203 447 9190

Andrology, Urology

Professional background

Mr Garaffa was born in Trieste, Italy and he graduated with honours at the faculty of Medicine and Surgery at the University of Trieste. Once finished his urological training, he completed a 3-year fellowship in Andrology and Reconstruction of the male urogenital tract at the Institute of Urology, University College London Hospitals, where he now a post there as a Consultant Uro-Andrologist and Honorary Senior Lecturer in Urology and Andrology. Mr Garaffa was awarded a PhD on male infertility by the University “La Sapienza” of Rome. He is very active in the field of clinical research having published in excess of 100 articles and book chapters on urology, andrology and reconstruction and has been the recipient of numerous prestigious awards.

Research interests

Erectile dyfunction, Peyronie's Disease, Penile Reconstruction, Phalloplasty, Urethral surgery


  1. Falcone M, Garaffa G. Penile Implant Satisfaction: Do We Really Know? J Sex
    Med. 2018 Feb;15(2):118-119. doi: 10.1016/j.jsxm.2017.12.014. PubMed PMID:
  2. Falcone M, Garaffa G, Gillo A, Dente D, Christopher AN, Ralph DJ. Outcomes of
    inflatable penile prosthesis insertion in 247 patients completing female to male
    gender reassignment surgery. BJU Int. 2018 Jan;121(1):139-144. doi:
    10.1111/bju.14027. Epub 2017 Oct 20. PubMed PMID: 28940910.
  3. Capece M, Gillo A, Cocci A, Garaffa G, Timpano M, Falcone M. Management of
    refractory ischemic priapism: current perspectives. Res Rep Urol. 2017 Aug
    29;9:175-179. doi: 10.2147/RRU.S128003. eCollection 2017. Review. PubMed PMID:
    28920056; PubMed Central PMCID: PMC5587151.
  4. Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current Management of Penile
    Fracture: An Up-to-Date Systematic Review. Sex Med Rev. 2017 Sep 2. pii:
    S2050-0521(17)30088-4. doi: 10.1016/j.sxmr.2017.07.009. [Epub ahead of print]
    Review. PubMed PMID: 28874325.
  5. Kalejaiye O, Raheem AA, Moubasher A, Capece M, McNeillis S, Muneer A,
    Christopher AN, Garaffa G, Ralph DJ. Sleep disorders in patients with erectile
    dysfunction. BJU Int. 2017 Dec;120(6):855-860. doi: 10.1111/bju.13961. Epub 2017
    Aug 8. PubMed PMID: 28710780.
  6. De Luca F, Garaffa G, Maurizi A, Manzi E, De Dominicis C, Ralph D. Total
    phallic reconstruction after penile amputation for donkey bite: Case report and
    review of the literature. Arch Ital Urol Androl. 2017 Jun 30;89(2):166-168. doi:
    10.4081/aiua.2017.2.166. Review. PubMed PMID: 28679197.
  7. Abdel Raheem A, Capece M, Kalejaiye O, Abdel-Raheem T, Falcone M, Johnson M, Ralph OG, Garaffa G, Christopher AN, Ralph DJ. Safety and effectiveness of
    collagenase clostridium histolyticum in the treatment of Peyronie's disease using
    a new modified shortened protocol. BJU Int. 2017 Nov;120(5):717-723. doi:
    10.1111/bju.13932. Epub 2017 Jul 14. PubMed PMID: 28612401.
  8. De Luca F, Garaffa G, Falcone M, Raheem A, Zacharakis E, Shabbir M, Aljubran
    A, Muneer A, Holden F, Akers C, Christopher N, Ralph DJ. Functional outcomes
    following immediate repair of penile fracture: a tertiary referral centre
    experience with 76 consecutive patients. Scand J Urol. 2017 Apr;51(2):170-175.
    doi: 10.1080/21681805.2017.1280532. Epub 2017 Jan 26. PubMed PMID: 28125311.
  9. Garaffa G, Ralph DJ. Ectopic Reservoir During Inflatable Penile Implant
    Surgery: Is It Now Standard of Care? J Sex Med. 2017 Mar;14(3):316-317. doi:
    10.1016/j.jsxm.2016.12.008. PubMed PMID: 28262101.
  10. Falcone M, Gillo A, Capece M, Raheem A, Ralph D, Garaffa G. The management of the acute ischemic priapism: A state of the art review. Actas Urol Esp. 2017
    Dec;41(10):607-613. doi: 10.1016/j.acuro.2017.02.004. Epub 2017 May 18. English, Spanish. PubMed PMID: 28528136.
  11. Garaffa G, Castiglione F. Kallikrein-kinin system: is it the fountain of
    youth? Asian J Androl. 2017 Jan-Feb;19(1):138-139. doi: 10.4103/1008-682X.192636. PubMed PMID: 27924789; PubMed Central PMCID: PMC5227664.
  12. Garaffa G, Ralph DJ. Free Flap Phalloplasty For Female To Male Gender
    Dysphoria. J Sex Med. 2016 Dec;13(12):1942-1947. doi: 10.1016/j.jsxm.2016.10.004. PubMed PMID: 27914566.
  13. Falcone M, Timpano M, Ceruti C, Sedigh O, Oderda M, Gillo A, Preto M, Sibona
    M, Garaffa G, Gontero P, Frea B, Rolle L. A Single-center Analysis on the
    Learning Curve of Male-to-Female Penoscrotal Vaginoplasty by Multiple Surgical
    Measures. Urology. 2017 Jan;99:234-239. doi: 10.1016/j.urology.2016.07.012. Epub  2016 Jul 18. PubMed PMID: 27443465.
  14. Falcone M, Garaffa G, Raheem A, Christopher NA, Ralph DJ. Total Phallic
    Reconstruction Using the Radial Artery Based Forearm Free Flap After Traumatic
    Penile Amputation. J Sex Med. 2016 Jul;13(7):1119-24. doi:
    10.1016/j.jsxm.2016.05.003. PubMed PMID: 27318022.
  15. 15: Chung E, Ralph D, Kagioglu A, Garaffa G, Shamsodini A, Bivalacqua T, Glina S, Hakim L, Sadeghi-Nejad H, Broderick G. Evidence-Based Management Guidelines on Peyronie's Disease. J Sex Med. 2016 Jun;13(6):905-23. doi:
    10.1016/j.jsxm.2016.04.062. PubMed PMID: 27215686.
  16. Rolle L, Falcone M, Ceruti C, Timpano M, Sedigh O, Ralph DJ, Kuehhas F,
    Oderda M, Preto M, Sibona M, Gillo A, Garaffa G, Gontero P, Frea B. A prospective
    multicentric international study on the surgical outcomes and patients'
    satisfaction rates of the 'sliding' technique for end-stage Peyronie's disease
    with severe shortening of the penis and erectile dysfunction. BJU Int. 2016
    May;117(5):814-20. doi: 10.1111/bju.13371. Epub 2015 Dec 21. PubMed PMID:
  17. Garaffa G, Ralph DJ. Is the modified sliding technique the way forward in
    Peyronie's surgery? BJU Int. 2015 Dec;116(6):840-1. doi: 10.1111/bju.13161.
    PubMed PMID: 26542328.
  18. Zacharakis E, De Luca F, Raheem AA, Garaffa G, Christopher N, Muneer A, Ralph
    DJ. Early insertion of a malleable penile prosthesis in ischaemic priapism allows
    later upsizing of the cylinders. Scand J Urol. 2015 Jun 26:1-4. [Epub ahead of
    print] PubMed PMID: 26116193.
  19. Garaffa G, Ralph DJ. Impact of the surgical correction of Peyronie's disease:
    a patient's perspective. BJU Int. 2015 May;115(5):679-80. doi: 10.1111/bju.13001.
    PubMed PMID: 25885561.
  20. Garaffa G, Kuehhas FE, De Luca F, Ralph DJ. Long-Term Results of
    Reconstructive Surgery for Peyronie's Disease. Sex Med Rev. 2015
    Apr;3(2):113-121. doi: 10.1002/smrj.42. Epub 2015 Dec 2. Review. PubMed PMID:
  21. Antonini G, Vicini P, Sanalone S, Garaffa G, Vitarelli A, De Berardinis E,
    Von Heland M, Giovannone R, Casciani E, Gentile V. Reply by authors. Arch Ital
    Urol Androl. 2014 Dec;86(4):304. PubMed PMID: 25803879.
  22. Zacharakis E, Garaffa G, Raheem AA, Christopher AN, Muneer A, Ralph DJ.
    Penile prosthesis insertion in patients with refractory ischaemic priapism: early
    vs delayed implantation. BJU Int. 2014 Oct;114(4):576-81. Erratum in: BJU Int.
    2016 Apr;117(4):E7. PubMed PMID: 25383397.
  23. Antonini G, Vicini P, Sansalone S, Garaffa G, Vitarelli A, De Berardinis E,
    Von Heland M, Giovannone R, Casciani E, Gentile V. Penile fracture: penoscrotal
    approach with degloving of penis after Magnetic Resonance Imaging (MRI). Arch
    Ital Urol Androl. 2014 Mar 28;86(1):39-40. doi: 10.4081/aiua.2014.1.39. PubMed
    PMID: 24704930.
  24. Garaffa G, Spilotros M, Christopher NA, Ralph DJ. Total phallic
    reconstruction using radial artery based forearm free flap phalloplasty in
    patients with epispadias-exstrophy complex. J Urol. 2014 Sep;192(3):814-20. doi:
    10.1016/j.juro.2014.03.105. Epub 2014 Apr 1. PubMed PMID: 24704015.
  25. Loreto C, Garaffa G, Dijnovic R, Barbagli G, Villa M, Sansalone S. Penile
    disassembly: anatomical surgical steps. BJU Int. 2013 Nov;112(7):1035-45. doi:
    10.1111/bju.12413. PubMed PMID: 24118959.
  26. Vitarelli A, Divenuto L, Fortunato F, Falco A, Pagliarulo V, Antonini G,
    Gentile V, Sciarra A, Salciccia S, Sansalone S, Di Placido MR, Garaffa G,
    Pagliarulo A. Long term patient satisfaction and quality of life with AMS700CX
    inflatable penile prosthesis. Arch Ital Urol Androl. 2013 Sep 26;85(3):133-7.
    doi: 10.4081/aiua.2013.3.133. PubMed PMID: 24085235.
  27. Garaffa G, Gentile V, Antonini G, Tsafrakidis P, Raheem AA, Ralph DJ. Penile
    reconstruction in the male. Arab J Urol. 2013 Sep;11(3):267-71. doi:
    10.1016/j.aju.2013.04.003. Epub 2013 Jun 12. Review. PubMed PMID: 26558091;
    PubMed Central PMCID: PMC4443016.
  28. Zacharakis E, Raheem AA, Freeman A, Skolarikos A, Garaffa G, Christopher AN,
    Muneer A, Ralph DJ. The efficacy of the T-shunt procedure and intracavernous
    tunneling (snake maneuver) for refractory ischemic priapism. J Urol. 2014
    Jan;191(1):164-8. doi: 10.1016/j.juro.2013.07.034. Epub 2013 Jul 24. PubMed PMID:
  29. Garaffa G, Trost LW, Serefoglu EC, Ralph D, Hellstrom WJ. Understanding the
    course of Peyronie's disease. Int J Clin Pract. 2013 Aug;67(8):781-8. doi:
    10.1111/ijcp.12129. Review. PubMed PMID: 23869679.
  30. Garaffa G, Ralph DJ. Penile Prosthesis Implantation in Acute and Chronic
    Priapism. Sex Med Rev. 2013 Jul;1(2):76-82. doi: 10.1002/smrj.10. Epub 2015 Oct
    18. Review. PubMed PMID: 27784586.
  31. Sansalone S, Garaffa G, Vespasiani G, Zucchi A, Kuehhas FE, Herwig R, Silvani
    M, Pecoraro S, Loreto C, Leonardi R. Glans reconstruction with the use of an
    inverted urethral flap after distal penile amputation for carcinoma. Arch Ital
    Urol Androl. 2013 Apr 19;85(1):24-7. doi: 10.4081/aiua.2013.1.24. PubMed PMID:
  32. Abdel Raheem A, Rushwan N, Garaffa G, Zacharakis E, Doshi A, Heath C, Serhal
    P, Harper JC, Christopher NA, Ralph D. Factors influencing intracytoplasmic sperm
    injection (ICSI) outcome in men with azoospermia. BJU Int. 2013
    Jul;112(2):258-64. doi: 10.1111/j.1464-410X.2012.11714.x. Epub 2013 Jan 29.
    PubMed PMID: 23356885.
  33. Garaffa G, Ralph DJ. Penile length and girth restoration in severe Peyronie's
    disease using circular and longitudinal grafting. BJU Int. 2013 Apr;111(4 Pt
    B):E220. doi: 10.1111/j.1464-410X.2012.11590.x. Epub 2012 Oct 26. PubMed PMID:
  34. Sansalone S, Garaffa G, Djinovic R, Antonini G, Vespasiani G, Ieria FP,
    Cimino S, Loreto C, Ralph DJ. Simultaneous total corporal reconstruction and
    implantation of a penile prosthesis in patients with erectile dysfunction and
    severe fibrosis of the corpora cavernosa. J Sex Med. 2012 Jul;9(7):1937-44. doi:
    10.1111/j.1743-6109.2012.02748.x. Epub 2012 Jun 6. PubMed PMID: 22672346.
  35. Garaffa G, Antonini G, Gentile V, Ralph DJ. Phalloplasty for the genetic
    male. Transl Androl Urol. 2012 Jun;1(2):103-8. doi:
    10.3978/j.issn.2223-4683.2012.05.05. Review. PubMed PMID: 26816694; PubMed
    Central PMCID: PMC4708208.
  36. Abdel Raheem A, Garaffa G, Rushwan N, De Luca F, Zacharakis E, Abdel Raheem
    T, Freeman A, Serhal P, Harper JC, Ralph D. Testicular histopathology as a
    predictor of a positive sperm retrieval in men with non-obstructive azoospermia.
    BJU Int. 2013 Mar;111(3):492-9. doi: 10.1111/j.1464-410X.2012.11203.x. Epub 2012
    May 15. PubMed PMID: 22583840.
  37. Garaffa G, Sansalone S, Ralph DJ. Penile reconstruction. Asian J Androl. 2013
    Jan;15(1):16-9. doi: 10.1038/aja.2012.9. Epub 2012 Mar 19. Review. PubMed PMID:
    22426595; PubMed Central PMCID: PMC3739136.
  38. Sansalone S, Garaffa G, Djinovic R, Egydio P, Vespasiani G, Miano R, Loreto
    C, Ralph DJ. Simultaneous penile lengthening and penile prosthesis implantation
    in patients with Peyronie's disease, refractory erectile dysfunction, and severe
    penile shortening. J Sex Med. 2012 Jan;9(1):316-21. doi:
    10.1111/j.1743-6109.2011.02509.x. Epub 2011 Oct 24. PubMed PMID: 22023552.
  39. Sansalone S, Garaffa G, Djinovic R, Pecoraro S, Silvani M, Barbagli G, Zucchi
    A, Vespasiani G, Loreto C. Long-term results of the surgical treatment of
    Peyronie's disease with Egydio's technique: a European multicentre study. Asian J
    Androl. 2011 Nov;13(6):842-5. doi: 10.1038/aja.2011.42. Epub 2011 Jul 11. PubMed
    PMID: 21743482; PubMed Central PMCID: PMC3752552.
  40. Garaffa G, Raheem AA, Ralph DJ. Penile fracture and penile reconstruction.
    Curr Urol Rep. 2011 Dec;12(6):427-31. doi: 10.1007/s11934-011-0201-5. Review.
    PubMed PMID: 21647621.
  41. Garaffa G, Raheem AA, Ralph DJ. An update on penile reconstruction. Asian J
    Androl. 2011 May;13(3):391-4. doi: 10.1038/aja.2011.29. Review. PubMed PMID:
    21540867; PubMed Central PMCID: PMC3739352.
  42. Garaffa G, Minervini A, Christopher NA, Minhas S, Ralph DJ. The management of
    residual curvature after penile prosthesis implantation in men with Peyronie's
    disease. BJU Int. 2011 Oct;108(7):1152-6. doi: 10.1111/j.1464-410X.2010.10023.x.
    Epub 2011 Feb 11. PubMed PMID: 21314814.
  43. Garaffa G, Shabbir M, Christopher N, Minhas S, Ralph DJ. The surgical
    management of lichen sclerosus of the glans penis: our experience and review of
    the literature. J Sex Med. 2011 Apr;8(4):1246-53. doi:
    10.1111/j.1743-6109.2010.02165.x. Epub 2011 Jan 6. Review. PubMed PMID: 21210959.
  44. Shabbir M, Muneer A, Kalsi J, Shukla CJ, Zacharakis E, Garaffa G, Ralph D,
    Minhas S. Glans resurfacing for the treatment of carcinoma in situ of the penis:
    surgical technique and outcomes. Eur Urol. 2011 Jan;59(1):142-7. doi:
    10.1016/j.eururo.2010.09.039. Epub 2010 Oct 20. PubMed PMID: 21050658.
  45. Garaffa G, Li C, Moncada I, Ralph DJ. Surgical management of erectile
    dysfunction. Arch Esp Urol. 2010 Oct;63(8):728-38. PubMed PMID: 21048283.
  46. Garaffa G, Ralph DJ. Words of wisdom. Re: penile reconstruction: is the
    radial forearm flap really the standard technique? Eur Urol. 2010
    Oct;58(4):634-5. PubMed PMID: 20848749.
  47. Raheem AA, Garaffa G, Raheem TA, Dixon M, Kayes A, Christopher N, Ralph D.
    The role of vacuum pump therapy to mechanically straighten the penis in
    Peyronie's disease. BJU Int. 2010 Oct;106(8):1178-80. doi:
    10.1111/j.1464-410X.2010.09365.x. Erratum in: BJU Int. 2016 Apr;117(4):E7. PubMed
    PMID: 20438558.
  48. Garaffa G, Ralph DJ, Christopher N. Total urethral construction with the
    radial artery-based forearm free flap in the transsexual. BJU Int. 2010
    Oct;106(8):1206-10. doi: 10.1111/j.1464-410X.2010.09247.x. PubMed PMID: 20201834.
  49. Garaffa G, Sacca A, Christopher AN, Ralph DJ. Circumcision is not mandatory
    in penile surgery. BJU Int. 2010 Jan;105(2):222-4. doi:
    10.1111/j.1464-410X.2009.08763.x. Epub 2009 Jul 7. PubMed PMID: 19594732.
  50. Garaffa G, Christopher NA, Ralph DJ. Total phallic reconstruction in
    female-to-male transsexuals. Eur Urol. 2010 Apr;57(4):715-22. doi:
    10.1016/j.eururo.2009.05.018. Epub 2009 May 19. PubMed PMID: 19477578.
  51. Rees R, Freeman A, Malone P, Garaffa G, Muneer A, Minhas S. Case study: the
    surgical management of angiokeratoma resulting from radiotherapy for penile
    cancer. ScientificWorldJournal. 2009 May 20;9:339-42. doi: 10.1100/tsw.2009.23.
    PubMed PMID: 19468654; PubMed Central PMCID: PMC5823195.
  52. Garaffa G, Raheem AA, Christopher NA, Ralph DJ. Total phallic reconstruction
    after penile amputation for carcinoma. BJU Int. 2009 Sep;104(6):852-6. doi:
    10.1111/j.1464-410X.2009.08424.x. Epub 2009 Feb 23. PubMed PMID: 19239449.
  53. Garaffa G, Muneer A, Freeman A, Abdel Raheem AM, Ralph DJ, Minhas S, Rees RW.
    Paraganglioma of the spermatic cord: case report and review of the literature.
    ScientificWorldJournal. 2008 Dec 25;8:1256-8. doi: 10.1100/tsw.2008.161. PubMed
    PMID: 19112537.
  54. Bettocchi C, Ditonno P, Palumbo F, Lucarelli G, Garaffa G, Giammusso B,
    Battaglia M. Penile prosthesis: what should we do about complications? Adv Urol.
    2008:573560. doi: 10.1155/2008/573560. Epub 2008 Nov 4. PubMed PMID: 19009029;
    PubMed Central PMCID: PMC2581729.
  55. Ralph DJ, Garaffa G, Muneer A, Freeman A, Rees R, Christopher AN, Minhas S.
    The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur
    Urol. 2009 Dec;56(6):1033-8. doi: 10.1016/j.eururo.2008.09.044. Epub 2008 Oct 1.
    PubMed PMID: 18930579.
  56. Ralph DJ, Garaffa G. Editorial comment on: Effect of sildenafil on
    middle-aged sexually active males with no erectile complaints: a randomized
    placebo-controlled double-blind study. Eur Urol. 2009 Apr;55(4):978. doi:
    10.1016/j.eururo.2008.04.097. Epub 2008 May 22. PubMed PMID: 18486305.
  57. Garaffa G, Christopher N, Ralph DJ. The management of genital lymphoedema.
    BJU Int. 2008 Aug;102(4):480-4. doi: 10.1111/j.1464-410X.2008.07559.x. Epub 2008
    Mar 5. PubMed PMID: 18325055.
  58. Liguori G, Garaffa G, Trombetta C, Bussani R, Bucci S, Belgrano E. Inguinal
    recurrence of malignant mesothelioma of the tunica vaginalis: one case report
    with delayed recurrence and review of the literature. Asian J Androl. 2007
    Nov;9(6):859-60. Review. PubMed PMID: 17968475.
  59. Garaffa G, Bettocchi C, Christopher N, Ralph D. Plexiform neurofibroma of the
    penis associated with erectile dysfunction due to arterial steeling. J Sex Med.
    2008 Jan;5(1):234-6. Epub 2007 Oct 24. PubMed PMID: 17961147.
  60. Trombetta C, Liguori G, Bucci S, Benvenuto S, Garaffa G, Belgrano E.
    Evaluation of tumor thrombi in the inferior vena cava with intraoperative
    ultrasound. World J Urol. 2007 Aug;25(4):381-4. Epub 2007 Jul 3. PubMed PMID:

GMC/GDC number: 6109979