Purpose of reviewThe purpose of this article is to report on the most recent findings on the current surgical treatments for sex reassignment surgery for both male-to-female and female-to-male transsexuals. Recent findingsFor male-to-female sex reassignment surgery, researches aim to refine the inverted peno-scrotal flap surgical technique in order to increase the neovaginal length and width, prevent complications and ameliorate the cosmetic outcome. Bowel segment vaginoplasty, used mainly for secondary cases, is becoming more and more common. For female-to-male sex reassignment surgery, the radial forearm flap is the only procedure that has proved to fulfil most of the patient expectations; however, because of a high complications rate, long recovery time and a large number of the required operations, and the absence of guarantee that patients will be satisfied, the free radial forearm flap is not the best option for every patient. Alternatives such as abdominal/groin flap, thigh flap and metaidoioplasty are very much used. SummaryIn order to provide the best care for transsexual patients, centres performing sex reassignment surgery should co-operate and implement both the refinements and the new techniques offered and/or requested.

Introduction The surgical techniques currently available for penile reconstruction for trans-men with gender dysphoria present with multiple drawbacks and often fail to meet patients' expectations. Literature reports three cases where penile transplantation has been performed for cis-men, with the last two cases being considered successful. Aim To determine whether an en bloc surgical dissection can be performed in a male cadaver, in order to include structures necessary for penile transplantation (from a deceased donor male) to a recipient with female genitalia in gender affirmation surgery. Method The study was conducted in the form of explorative dissections of the genital and pelvic regions of three male cadavers preserved in phenol-ethanol solution. Results The first two dissections failed to explant adequately all the relevant structures. The third dissection, which was performed along the pubic arch and through the perineum, succeeded in explanting the relevant structures: it, in fact, allowed for identification and adequate transection of urethra, vessels, dorsal nerves, crura of corpora cavernosa, and bulb of corpus spongiosum, in en bloc explantation of male genitalia. Conclusions It is possible to explant the penis and associated vessels, nerves, and urethra en bloc from a cadaver. This study suggests a surgical technique for en bloc explantation aiming for transplantation of the penis from a cadaveric donor male to a recipient with female genitalia.