Mr Giulio Garaffa

Tel: 0203 447 9190


Professional background

Mr Giulio Garaffa has been trained in Italy and the UK before being appointed as a Consultant Uro-Andrological Surgeon and Honorary Senior Lecturer in Urology at the Institute of Urology, University College London Hospitals.

His main areas of expertise are erectile dysfunction, Peyronie’s disease, complex penile reconstruction, microsurgery and infertility. He has been awarded an MD on vascular and nervous microsurgery and more recently a PhD on the genetic basis of male factor infertility.

Very active in the field of clinical research, Mr Garaffa has published more than 100 articles and book chapters in international journals and is regularly invited worldwide to give lectures and to perform live surgery.

A fellow of the European Committee of Sexual Medicine, Mr Garaffa is also part of the educational committee of the European Society of Sexual Medicine, which strives to provide excellent standards of training in the field of Andrology and Sexual Medicine to Urologists.

He is a dedicated and well-recognized trainer in Andrology and Reconstruction and he often runs international training courses for Surgeons.

Research interests

Andrology and reconstruction of the lower male genital tract


1: 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 (CCH) (Xiapex(®) ) in the treatment of
Peyronie's Disease using a new modified shortened protocol. BJU Int. 2017 Jun 14.
doi: 10.1111/bju.13932. [Epub ahead of print] PubMed PMID: 28612401.

2: 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 May
17. pii: S0210-4806(17)30045-1. doi: 10.1016/j.acuro.2017.02.004. [Epub ahead of
print] English, Spanish. PubMed PMID: 28528136.

3: 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.

4: 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 Jan 26:1-9. doi:
10.1080/21681805.2017.1280532. [Epub ahead of print] PubMed PMID: 28125311.

5: 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.

6: 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.

7: 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.

8: 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.

9: 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.

10: 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:

11: 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.

12: 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.

13: 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.

14: 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:

15: 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.

16: 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.

17: 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.

18: 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.

19: 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.

20: 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.

21: 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.

22: 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:

23: 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.

24: 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.

25: 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:

26: 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.

27: 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:

28: 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.

29: 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.

30: 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.

31: 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.

32: 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.

33: 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.

34: 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.

35: 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.

36: 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.

37: 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.

38: 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.

39: 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.

40: 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.

41: 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.

42: 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.

43: 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.

44: 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.

45: 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.

46: 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.

47: 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.

48: 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.

49: 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.

50: 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.

51: 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.

52: 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.

53: 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.

54: 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:

55: Ralph DJ, Garaffa G, García MA. Reconstructive surgery of the penis. Curr
Opin Urol. 2006 Nov;16(6):396-400. Review. PubMed PMID: 17053518.

56: Liguori G, Trombetta C, Pomara G, Amodeo A, Bucci S, Garaffa G, Francesca F,
Belgrano E. Major invasive surgery for urologic cancer in octogenarians with
comorbid medical conditions. Eur Urol. 2007 Jun;51(6):1600-4; discussion 1605.
Epub 2006 Aug 11. PubMed PMID: 16962701.

57: Liguori G, Garaffa G, Bertolotto M, Trombetta C. Intraoperative ultrasound:
utility in case of vena caval tumour thrombus. Arch Ital Urol Androl. 2005
Mar;77(1):84-6. Review. PubMed PMID: 15906802.

58: Liguori G, Garaffa G, Trombetta C, Capone M, Bertolotto M, Pozzi-Mucelli F,
Belgrano E. High-flow priapism (HFP) secondary to Nesbit operation: management by
percutaneous embolization and colour Doppler-guided compression. Int J Impot Res.
2005 May-Jun;17(3):304-6. PubMed PMID: 15690066.

59: Savoca G, Scieri F, Pietropaolo F, Garaffa G, Belgrano E. Straightening
corporoplasty for Peyronie's disease: a review of 218 patients with median
follow-up of 89 months. Eur Urol. 2004 Nov;46(5):610-4; discussion 613-4. PubMed
PMID: 15474271.

60: Trombetta C, Liguori G, Bucci S, Salamè L, Garaffa G, Cova M, Belgrano E.
Radiological evaluation of vaginal width and depth in male-to-female transsexuals
by the use of magnetic resonance imaging. World J Urol. 2004 Nov;22(5):405-8.
Epub 2004 Aug 18. PubMed PMID: 15322806.

61: Liguori G, Trombetta C, Garaffa G, Bucci S, Gattuccio I, Salamè L, Belgrano
E. Color Doppler ultrasound investigation of varicocele. World J Urol. 2004
Nov;22(5):378-81. Epub 2004 Aug 18. Review. PubMed PMID: 15322805.

GMC/GDC number: 6109979