Sex Reassignment Surgery in Male to Female Transsexuals

Bouman, F. G.

doi:10.1097/00000637-198812000-00006

Cited by 38 publications

(18 citation statements)

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“…However, there are published vaginal stenosis rates of 5–66%. Analysed by technique vaginal stenosis was documented in 6–15% using penoscrotal skin flaps [2,3,5], 5–55% with inversion of penile skin only [4–15] and 8–45% using free‐skin grafts [16–19].…”

Section: Discussionmentioning

confidence: 99%

Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

et al. 2007

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penectomy, urethroplasty and labiaplasty, 207 (93%) had formation of a neoclitoris, and 202 (91%) had a skin-lined neovagina. The median (range) age was 41 (19-76) years. The median hospital stay was 10 (6-21) days. A record of the first outpatient visit was available in 197 (84.5%) cases. The median time to follow up was 56 (8-351) days. Over all, 82.2% had an adequate vaginal depth, with a median depth of 13 (5-15) cm and 6.1% had developed vaginal stenosis. Three (1.7%) patients had had a vaginal prolapse, two (1.1%) had a degree of vaginal skin flap necrosis and one (0.6%) was troubled with vaginal hair growth. In 86.3% of the patients the neoclitorizes were sensitive. There was urethral stenosis in 18.3% of the patients and 5.6% complained of spraying of urine. Minor corrective urethral surgery was undertaken in 36 patients including 42 urethral dilatations, and eight meatotomies were performed. At the first clinic visit 174 (88.3%) patients were 'happy', 13 (6.6%) were 'unhappy' and 10 (5.1%) made no comment. Of the 233 patients, we successfully contacted 70 (30%). All had had penectomy and labioplasty, 64 (91%) had a clitoroplasty and 62 (89%) a neovagina. The median age was 43 (19-76) years and the median follow up was 36 (9-96) months. Overall, 63 (98%) had a sensate neoclitoris, with 31 (48%) able to achieve orgasm; nine (14%) were hypersensitive. Vaginal depth was considered adequate by 38 (61%) and 14 (23%) had or were having regular intercourse. Vaginal hair growth troubled 18 (29%), four (6%) had a vaginal prolapse and two (3%) had vaginal necrosis. Urinary problems were reported by 19 (27%) patients, of these 18 (26%) required revision surgery, 14 (20%) complained of urinary spraying, 18 (26%) had an upward directed stream and 16 (23%) had urethral stenosis. The patients deemed the cosmetic result acceptable in 53 (76%) cases and 56 (80%) said the surgery met with their expectations. CONCLUSIONThis is largest series of early results after male to female FG. Complications are common after this complex surgery and long-term follow-up is difficult, as patients tend to relocate at the start of their 'new life' after FG. There were good overall cosmetic and functional results, with a sustained high patient satisfaction. KEYWORDS OBJECTIVETo examine the early and late surgical outcomes of feminizing genitoplasty (FG) in adult transsexuals in a UK single surgeon practice over a 10-year period. PATIENTS AND METHODSComputerized and manual databases were searched over the period 1994-2004 to identify patients who had undergone male to female FG. Case-notes were retrieved and analysed to identify epidemiological data, the number and type of perioperative problems, early results at outpatient review, late occurring problems and patient satisfaction. A telephone questionnaire was then conducted targeting all FG patients in our series. The questions were directed at identifying surgical complications, outcome and patient satisfaction. RESULTSIn all, 233 case-notes were identified and 222 (95%) were retrieved....

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Section: Discussionmentioning

confidence: 99%

Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

et al. 2007

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“… The inverted penile skin with a small triangular scrotal skin flaps to “break” the circular introitus[ 18 ] The pedicled penile skin tube may be split open to form a rectangular flap, posteriorly pedicled scrotal skin flap[ 19 ] The inverted penile skin tube may be applied based on an inferior pedicle. [ 20 ] …”

Section: Discussionmentioning

confidence: 99%

Application of embryonic equivalents in male-to-female sex reassignment surgery

Thalaivirithan

Sethu

Ramachandran

et al. 2018

Indian J Plast Surg

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Introduction:The feeling of incongruence between phenotypic sex and psychological recognition of self-gender is termed gender dysphoria. Transsexualism is the most extreme form of this disorder.Aims and Objectives:The aims and objectives of the study are to evaluate the esthetic and functional outcome of embryonic equivalents-based male-to-female sex reassignment surgery in transwomen using the institutional scoring system.Materials and Methods:Thirty transwomen who had undergone male-to-female embryonic equivalents-based sex reassignment surgery (MFEEbSRS) from October 2012 to March 2016 were retrospectively studied. The outcome was evaluated by two independent plastic surgeons, based on interview with the individuals, visual assessment, and measurements.Surgical Technique:Clitoris was created from reduced glans on dorsal penile pedicle mounted on the crura of the conjoined corpora cavernosa. De-gloved unfurled proximal penile skin formed the introitus, hood for clitoris and labia minora. Neo-external urethral meatus was fashioned from the distal portion of the bulbar urethra. Distal de-gloved inverted penile tube flap was used for the creation of neovagina. Reduced scrotal flaps formed the labia majora.Observation and Results:The maximum length of neovagina in the study was 12 cm, and the average length was 9.8 cm. Based on our institutional scoring system for the assessment of esthetic and functional outcome, we got excellent results in all transwomen.Conclusion:The esthetic and functional outcome in all the patients was good. All patients were relieved of their primordial feminine tension and satisfied with the surgery. Their personality, lifestyle, and self-esteem improved remarkably following surgery.

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“…After genital transformation, orgasms remain possible, although half of the male-to-female transsexuals are not sexually active, or at least do not use their neovagina [3]. In female-to-male transsexuals, the clitoris remains within reach for stimulation.…”

Section: Female-to-male Transformationmentioning

confidence: 99%

Multidisciplinary treatment of patients with gender dysphoria

et al. 1993

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Summary.Patients with gender dysphoria are best treated by a multidisciplinary team. Such a team consists of a nucleus of specialists who sees the patient frequently and a peripheral group that sees patients incidentally. The tasks of each team member are described, and the value of the multidisciplinary cooperation is highlighted. Gender dysphoria patients are better treated with a team approach than with treatment by individual specialists who are working independently of one another.

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Sex Reassignment Surgery in Male to Female Transsexuals

Cited by 38 publications

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Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

Application of embryonic equivalents in male-to-female sex reassignment surgery

Multidisciplinary treatment of patients with gender dysphoria

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