Comparison of two methods of vagina construction in transsexuals

Twenty-seven male-to-female transsexuals underwent genital transformation. The cosmetic and functional results of 11 vagina constructions using only inverted penile skin were compared with 16 constructions using penile and scrotal skin flaps. Subjective (interview) and objective (physical examination) results are presented. The main conclusions are that vaginal width and subjective evaluation of functional aspects were clearly better after penile and scrotal skin inversion, especially when there was adequate dilatation by the patient. In addition, fewer complications were encountered. Cosmesis was judged better in the penile skin inversion group.