A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients
✍ Scribed by Juergen Schaff; Nikolaos A. Papadopulos
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 371 KB
- Volume
- 29
- Category
- Article
- ISSN
- 0738-1085
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✦ Synopsis
Background: Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female-tomale transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creation with free sensate osteofasciocutaneous fibula (n 5 31) or radial forearm (n 5 6) flap; and third, urethral connection, neoscrotum formation, and testicle prosthesis implantation. Results: Occasionally, wound healing disturbance and slight asymmetry of the breasts was observed, as well as colpocleisis revision needed. Partial flap necrosis took place in 6 patients, while 12 presented urethral stricture and 6 a fistula. Despite inferior neophallus sensibility, patients whose neophallus was created using fibula flap experienced better sexual intercourse. However, overall patients' satisfaction was superior. Conclusions: The applied protocol demonstrates the effectiveness of such a multistage and interdisciplinary approach for female-to-male transsexuals, offering an essential improvement of their quality of life, concerning their successful integration into the reassigned gender position in the society. V