One-stage phalloplasty in transsexuals

Area of Science:

• Reconstructive surgery
• Gender affirmation surgery
• Microsurgery

Background:

• Traditional phalloplasty in transsexual individuals often involves multiple stages and lengthy recovery periods.
• Existing methods utilize abdominal or thigh flaps, which can lead to significant morbidity and aesthetic concerns.

Purpose of the Study:

• To describe a novel one-stage phalloplasty technique for female transsexuals.
• To achieve true genital sensibility through nerve anastomosis.
• To simplify the phalloplasty procedure, reducing surgical time and recovery.

Main Methods:

• A modified Chinese forearm flap was employed, with cutaneous nerves anastomosed to genital branches of ilioinguinal, iliohypogastric, and pudendal nerves.
• Immediate hysterectomy and vaginal closure were performed.
• Vaginal skin was utilized for neoscrotum construction and glans coverage.
• A vaginal flap around a catheter formed the urethra, supported by the forearm flap's dermal tube (corpus spongiosum).
• Autogenous costal cartilage served as a stent for corpora cavernosa substitution.

Main Results:

• Successful one-stage phalloplasty was achieved in female transsexuals.
• The technique facilitated the creation of a neophallus with potential for true genital sensibility.
• The procedure integrated urethra, neoscrotum, and glans reconstruction within a single surgical session.

Conclusions:

• The modified Chinese forearm flap offers a viable and efficient one-stage solution for phalloplasty in female transsexuals.
• This technique enhances functional and sensory outcomes, potentially improving patient satisfaction.
• Further research should evaluate long-term functional and aesthetic results.