Total phalloplasty in female transsexuals

17 October 2011

Research on reconstructive surgery from Belgrade, Serbia has won the first prize for Best Abstract from Karl Storz granted during the EAU 7th South Eastern European Meeting (SEEM) held over the weekend in Skopje.

We are reprinting below the original, unedited abstract submitted by winner M. Djordjevic and colleagues:

Total phalloplasty in female transsexuals: technique and outcomes

Djordjevic M., Kojic S., Stanojevic D., Jocic D., Bizic M. University of Belgrade, Belgrade Gender Dysphoria Team, Belgrade, Serbia

Introduction & Objectives: Total phalloplasty includes creation of neophallus from an extragenital tissue, large enough to enable insertion of penile prosthesis and penetration during sexual intercourse and is usually done as a separate procedure.

We evaluated principles of technique and outcomes using latissimus dorsi microvascular free flap phalloplasty in female transsexuals.

Material & Methods: Between May 2007 and March 2011, 42 female transsexuals, aged 21 – 58 years (mean 37 years) underwent sex reassignment surgery that included: Removal of internal/external female genitalia, creation of neophallus using microvascular latissimus dorsi free flap, clitoral incorporation into the neophallus, urethral lengthening and insertion of testicle prosthesis into the scrotum created from joined labia majora. Penile prosthesis insertion was done 6 to 12 months later.

Results: Follow-up was from 6 to 48 months (mean 31 months). The length of neophallus ranged from 13–17cm with circumference from 11–14 cm. There was no partial or total necrosis of the phallus. Urethral fistula occurred in 5 cases and repaired 3 months later.

Conclusions: Total phalloplasty is feasible and safe surgical procedure. The main advantage is complete reconstruction of neophallus that avoids multi-staged gender reassignment surgery in female transsexuals. Our results confirmed successful outcome.

Source: EAU 7th South Eastern European Meeting (SEEM), Poster Session S13, European Urology Supplements, Volume 10, Issue 9, October 2011

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