A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients
Background: Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female‐to‐male transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creati...
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| Veröffentlicht in: | Microsurgery 2009, Vol.29 (5), p.413-419 |
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| creator | Schaff, Juergen Papadopulos, Nikolaos A. |
| description | Background:
Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female‐to‐male transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creation with free sensate osteofasciocutaneous fibula (n = 31) or radial forearm (n = 6) flap; and third, urethral connection, neoscrotum formation, and testicle prosthesis implantation.
Results:
Occasionally, wound healing disturbance and slight asymmetry of the breasts was observed, as well as colpocleisis revision needed. Partial flap necrosis took place in 6 patients, while 12 presented urethral stricture and 6 a fistula. Despite inferior neophallus sensibility, patients whose neophallus was created using fibula flap experienced better sexual intercourse. However, overall patients' satisfaction was superior.
Conclusions:
The applied protocol demonstrates the effectiveness of such a multistage and interdisciplinary approach for female‐to‐male transsexuals, offering an essential improvement of their quality of life, concerning their successful integration into the reassigned gender position in the society. © 2009 Wiley‐Liss, Inc. Microsurgery 2009. |
| doi_str_mv | 10.1002/micr.20647 |
| format | Article |
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Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female‐to‐male transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creation with free sensate osteofasciocutaneous fibula (n = 31) or radial forearm (n = 6) flap; and third, urethral connection, neoscrotum formation, and testicle prosthesis implantation.
Results:
Occasionally, wound healing disturbance and slight asymmetry of the breasts was observed, as well as colpocleisis revision needed. Partial flap necrosis took place in 6 patients, while 12 presented urethral stricture and 6 a fistula. Despite inferior neophallus sensibility, patients whose neophallus was created using fibula flap experienced better sexual intercourse. However, overall patients' satisfaction was superior.
Conclusions:
The applied protocol demonstrates the effectiveness of such a multistage and interdisciplinary approach for female‐to‐male transsexuals, offering an essential improvement of their quality of life, concerning their successful integration into the reassigned gender position in the society. © 2009 Wiley‐Liss, Inc. Microsurgery 2009.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.20647</identifier><identifier>PMID: 19399883</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Female ; Humans ; Male ; Patient Satisfaction ; Penis - surgery ; Reconstructive Surgical Procedures - methods ; Surgical Flaps ; Transsexualism - surgery</subject><ispartof>Microsurgery, 2009, Vol.29 (5), p.413-419</ispartof><rights>Copyright © 2009 Wiley‐Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3967-e1c77ce1a1528ae34d2061aa279c2d4f92aa8f0d9a8bcaa620a20127b91498623</citedby><cites>FETCH-LOGICAL-c3967-e1c77ce1a1528ae34d2061aa279c2d4f92aa8f0d9a8bcaa620a20127b91498623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmicr.20647$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.20647$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,4024,27923,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19399883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaff, Juergen</creatorcontrib><creatorcontrib>Papadopulos, Nikolaos A.</creatorcontrib><title>A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Background:
Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female‐to‐male transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creation with free sensate osteofasciocutaneous fibula (n = 31) or radial forearm (n = 6) flap; and third, urethral connection, neoscrotum formation, and testicle prosthesis implantation.
Results:
Occasionally, wound healing disturbance and slight asymmetry of the breasts was observed, as well as colpocleisis revision needed. Partial flap necrosis took place in 6 patients, while 12 presented urethral stricture and 6 a fistula. Despite inferior neophallus sensibility, patients whose neophallus was created using fibula flap experienced better sexual intercourse. However, overall patients' satisfaction was superior.
Conclusions:
The applied protocol demonstrates the effectiveness of such a multistage and interdisciplinary approach for female‐to‐male transsexuals, offering an essential improvement of their quality of life, concerning their successful integration into the reassigned gender position in the society. © 2009 Wiley‐Liss, Inc. Microsurgery 2009.</description><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Patient Satisfaction</subject><subject>Penis - surgery</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Surgical Flaps</subject><subject>Transsexualism - surgery</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9v1DAQxS0EokvhwgdAPnFASvGfJLa5VatSKhWQqiIQF2vWmagGJ07trLZ75JvjkgVucLJG_r2nefMIec7ZCWdMvB68SyeCtbV6QFacGV0J1YiHZMWU1BVnujkiT3L-xhgzRpnH5IgbaYzWckV-nNIRd3RKcY4uBtrHRF0cpoAz0ukGQohTgDzv6c7PN7RPiDTjmKF8w9gVIQYY_FjmjsY8Y-whOx_ddoYR4zbTPsCU39CzuwmTx9Eh9SOVik4wl3HOT8mjHkLGZ4f3mHx6e3a9flddfjy_WJ9eVk6aVlXInVIOOfBGaEBZdyUxBxDKONHVvREAumedAb1xAK1gIBgXamN4bXQr5DF5ufiWrLdbzLMdfHYYwrKnbVXdtLxu_wsKLppGCl7AVwvoUsw5YW-n5AdIe8uZvW_G3jdjfzVT4BcH1-1mwO4veqiiAHwBdj7g_h9W9v3F-uq3abVofLn83R8NpO8ljlSN_fzh3Kr19Vetrr5YJX8CTKyqag</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>Schaff, Juergen</creator><creator>Papadopulos, Nikolaos A.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>2009</creationdate><title>A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients</title><author>Schaff, Juergen ; Papadopulos, Nikolaos A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3967-e1c77ce1a1528ae34d2061aa279c2d4f92aa8f0d9a8bcaa620a20127b91498623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Patient Satisfaction</topic><topic>Penis - surgery</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Surgical Flaps</topic><topic>Transsexualism - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaff, Juergen</creatorcontrib><creatorcontrib>Papadopulos, Nikolaos A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaff, Juergen</au><au>Papadopulos, Nikolaos A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients</atitle><jtitle>Microsurgery</jtitle><addtitle>Microsurgery</addtitle><date>2009</date><risdate>2009</risdate><volume>29</volume><issue>5</issue><spage>413</spage><epage>419</epage><pages>413-419</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><abstract>Background:
Herein, we present our latest protocol of following three operative stages for complete phalloplasty, applied in 37 female‐to‐male transsexuals: first, mastectomy, ovariohysterectomy, urethral lengthening, vaginectomy, colpocleisis, and neourethra prelamination; second, neophallus creation with free sensate osteofasciocutaneous fibula (n = 31) or radial forearm (n = 6) flap; and third, urethral connection, neoscrotum formation, and testicle prosthesis implantation.
Results:
Occasionally, wound healing disturbance and slight asymmetry of the breasts was observed, as well as colpocleisis revision needed. Partial flap necrosis took place in 6 patients, while 12 presented urethral stricture and 6 a fistula. Despite inferior neophallus sensibility, patients whose neophallus was created using fibula flap experienced better sexual intercourse. However, overall patients' satisfaction was superior.
Conclusions:
The applied protocol demonstrates the effectiveness of such a multistage and interdisciplinary approach for female‐to‐male transsexuals, offering an essential improvement of their quality of life, concerning their successful integration into the reassigned gender position in the society. © 2009 Wiley‐Liss, Inc. Microsurgery 2009.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>19399883</pmid><doi>10.1002/micr.20647</doi><tpages>7</tpages></addata></record> |
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| ispartof | Microsurgery, 2009, Vol.29 (5), p.413-419 |
| issn | 0738-1085 1098-2752 |
| language | eng |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Female Humans Male Patient Satisfaction Penis - surgery Reconstructive Surgical Procedures - methods Surgical Flaps Transsexualism - surgery |
| title | A new protocol for complete phalloplasty with free sensate and prelaminated osteofasciocutaneous flaps: Experience in 37 patients |
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