Sex Reassignment Surgery in the Female-to-Male Transsexual.

In female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy (endoscopically assisted). The next operative procedure consists of the genital transformation and includes a vaginectomy, a reconstruction of the horizontal part of the urethra, a scrotoplasty and a penile reconstruction usually with a radial forearm flap (or an alternative). After about one year, penile (erection) prosthesis and testicular prostheses can be implanted when sensation has returned to the tip of the penis.

Penile reconstruction: is the radial forearm flap really the standard technique?

Background: The ideal goals in penile reconstruction are well described, but the multitude of flaps used for phalloplasty only demonstrates that none of these techniques is considered ideal. Still, the radial forearm flap is the most frequently used flap and universally considered as the standard technique.

Methods: In this article, the authors describe the largest series to date of 287 radial forearm phalloplasties performed by the same surgical team.

Scrotal reconstruction in female-to-male transsexuals: a novel scrotoplasty.

Background: One of the goals of genital construction in female-to-male transsexuals is the creation of an aesthetically acceptable result, both for phallus and scrotum, leaving minimal morbidity and recreating function. In the last 15 years, transsexuals have become more demanding, and scrotoplasty has received more attention than before. Traditional flaps for scrotal reconstruction in a biological male do not really apply in transsexuals: the labia majora seem to achieve the best results; still, they may not provide enough tissue and can be located much too posteriorly.

Chest-wall contouring surgery in female-to-male transsexuals: a new algorithm.

Background: In female-to-male transsexuals, the first surgical procedure in their reassignment surgery consists of the subcutaneous mastectomy. The goals of subcutaneous mastectomy are removal of breast tissue, removal of excess skin, reduction and proper positioning of the nipple and areola, and ideally, minimization of chest-wall scars. The authors present the largest series to date of female-to-male transsexuals who have undergone subcutaneous mastectomy.

Phalloplasty: a valuable treatment for males with penile insufficiency.

Objectives: To apply a phalloplasty technique used in female-to-male transsexual surgery in male patients with penile insufficiency.

Methods: Seven male patients (aged 15 to 42 years) were treated with phalloplasty (6 with radial forearm free flap and one with anterolateral thigh flap) between March 2004 and April 2006 (follow-up, 9 to 34 months). All patients suffered psychologically from their condition, with low self-esteem and sexual and relational dysfunction.

Genital sensitivity after sex reassignment surgery in transsexual patients.

Background: Tactile and erogenous sensitivity in reconstructed genitals is one of the goals in sex reassignment surgery. Since November 1993 until April 2003, a total of 105 phalloplasties with the radial forearm free flap and 127 vaginoclitoridoplasties with the inverted penoscrotal skin flap and the dorsal glans pedicled flap have been performed at Ghent University Hospital. The specific surgical tricks used to preserve genital and tactile sensitivity are presented.

One-stage penectomy and phalloplasty for epithelioid sarcoma of the penis in an adolescent.

Epithelioid sarcoma (ES) of the penis is a rare tumour. We present a case of ES of the penis in a 16-yr-old boy, for which penectomy and immediate reconstruction with a free forearm phalloplasty, including a urethral reconstruction, was performed. Because total penectomy is a dramatic life event for any patient, the option of immediate penile reconstruction is presented.

Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals.

Learning Objectives: After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2.

Impact of sex reassignment surgery on lower urinary tract function.

Objective: To investigate the effects of sex reassignment surgery (SRS) on lower urinary tract function.

Methods: A questionnaire concerning voiding habits and lower urinary tract symptoms after sex reassignment surgery, was given to 24 female-to-male transsexuals (FTM) and 31 male-to-female transsexuals (MTF), who respectively underwent phalloplasty and vaginoplasty. For this study only Dutch speaking patients were selected.