[Transsexualism: surgical aspects. An experience of the plastic surgical unit's in Bordeaux]

After briefly reviewing the history of transsexual surgery, the authors explain their technical choices and present their experience based on a series of 19 patients, 11 male transsexuals and 8 female transsexuals. The results are analysed. The potential complications of surgery in female transsexuals are those of microsurgical techniques aggravated by treatment with testosterone, as well as urethral fistulae and strictures. In addition to prevention of thromboses, the authors palliate these complications by ulnar elongation of the radial forearm flap in order to minimise the factors responsible for urethral fistulae, combined with enlargement of this flap to decrease the risk of stricture. The complications in male transsexuals essentially consist of rectoneovaginal fistulae. Problems of the depth of the neovagina are also important. Two rectoneovaginal fistulae were observed in this series of 11 patients, both treated medically. The unit's experience in this field will be continued in order to further improve the results.