This study is aimed to compare outcomes of penile-scrotal flap vaginoplasty to inverted penile skin flap expanded with spatulated urethra as a singlecentre experience. Data regarding vaginoplasty performed between May 2003 and January 2014 were reviewed. Subjects were divided into two groups according to the surgical technique performed: perineal- scrotal flap vaginoplasty (Group A), and inverted penile skin flap expanded with spatulated urethra vaginoplasty (Group B). All patients underwent to psychological analysis before surgery. Functional follow-up was based on a modified validated Female Sexual Function Index. Overall, 67 patients with a mean (SD) age of 34 (±9.38) years underwent to surgery. 41 patients were included into the Group A and 26 into the Group B. Mean operative time among Groups A and B was 316 (±101.65) and 594 (±89.06) minutes, respectively (p<0.0001). Longer postoperative hospitalization was shown in Group B (14 days ± 4,51) than in Group A (10 days ± 2,49); (p<0.0001). Group B patients showed a higher anemization rate requiring blood transfusion (p=0.00014) as well as compressive neuropathy (p=0.038). In addition to this, necrosis of the skin flap was reported in 8 patients of Group B (p<0.0001). Comprehensive functional follow-up data was included; spontaneous vaginal lubrication was not reported in 82.4% of Group A vs 12.5% cases of Group B (p=0.0085). When compared to penile-scrotal flap vaginoplasty, inverted penile skin flap expanded with spatulated urethra technique shows an increased risk of complications with comparable satisfaction rates whereas a higher spontaneous vaginal lubrication is reported. Sexological support is of utmost importance in this setting.

6. Le criticità della condizione transgenere nel contesto carcerario: le prassi e le normative di riferimento Anna Lorenzetti 6.1. Cenni introduttivi 6.2. La difficoltà di collocare le persone transgenere negli istituti di pena 6.3. La tutela della salute della persona trans detenuta 6.3.1. La difficoltosa assunzione di ormoni in carcere 6.3.2. La variabilità nelle tutele durante la detenzione: le diverse fasi del percorso di transizione indice 6.4. Le persone trans come "disturbo" della vita carceraria 6.5. Cenni conclusivi 7. Cosa si potrebbe e cosa si dovrebbe fare: alcune raccomandazioni per la tutela dei diritti delle persone transgender e transessuali in carcere