Flap Combination Phalloplasty in Female-to-Male Transsexuals.
Female-to-Male Transsexual
Flap Combination Phalloplasty
Sex Reassignment Surgery
Single Flap Phalloplasty
Journal
The journal of sexual medicine
ISSN: 1743-6109
Titre abrégé: J Sex Med
Pays: Netherlands
ID NLM: 101230693
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
04
01
2019
revised:
12
02
2019
accepted:
14
02
2019
pubmed:
22
3
2019
medline:
19
6
2020
entrez:
22
3
2019
Statut:
ppublish
Résumé
Although phalloplasty with a free radial forearm (RF) flap is the gold standard for sex reassignment surgery in female-to-male transsexuals, it can result in unsightly scars, lymphedema, and numbness of the hand. To introduce the concept of flap combination phalloplasty and its clinical application. This is a retrospective chart review study of patients undergoing phalloplasty using various multiple flaps. Demographic data, surgical data, and outcomes were recorded. Of the 15 cases, 5 were urethral fistulas; 4 were venous thrombosis; 2 were urethral calculus; and 1 was a partial flap loss. 15 patients were included (age range 25-43 years, median 34 years). An RF flap and a deep inferior epigastric artery perforator flap combination were most frequently used. The median operative time for flap combination phalloplasty was 10.5 hours (range 6.5-12.5 hours). There was no total flap necrosis, but there was 1 case of partial flap loss. There were urethral fistulas in 5, venous thrombosis in 4, and urethral calculus in 2 cases. Flap combination phalloplasty will become the third option when both the RF flap and the anterolateral thigh pedicle flap are not useful. Flap combination phalloplasty is a complex operative procedure with a prolonged operative time, but it can provide more flap selection and reduce the morbidity at each donor site. Choosing from many different options can be beneficial to patients. Flap combination phalloplasty has a similar complication rate to other procedures and has advantages in terms of flexibility and less donor site morbidity; it may thus be an option when either the RF flap or the anterolateral thigh pedicle flap cannot be used. Namba Y, Watanabe T, Kimata Y. Flap Combination Phalloplasty in Female-to-Male Transsexuals. J Sex Med 2019;16:934-941.
Sections du résumé
BACKGROUND
BACKGROUND
Although phalloplasty with a free radial forearm (RF) flap is the gold standard for sex reassignment surgery in female-to-male transsexuals, it can result in unsightly scars, lymphedema, and numbness of the hand.
AIM
OBJECTIVE
To introduce the concept of flap combination phalloplasty and its clinical application.
METHODS
METHODS
This is a retrospective chart review study of patients undergoing phalloplasty using various multiple flaps. Demographic data, surgical data, and outcomes were recorded.
OUTCOMES
RESULTS
Of the 15 cases, 5 were urethral fistulas; 4 were venous thrombosis; 2 were urethral calculus; and 1 was a partial flap loss.
RESULTS
RESULTS
15 patients were included (age range 25-43 years, median 34 years). An RF flap and a deep inferior epigastric artery perforator flap combination were most frequently used. The median operative time for flap combination phalloplasty was 10.5 hours (range 6.5-12.5 hours). There was no total flap necrosis, but there was 1 case of partial flap loss. There were urethral fistulas in 5, venous thrombosis in 4, and urethral calculus in 2 cases.
CLINICAL IMPLICATIONS
CONCLUSIONS
Flap combination phalloplasty will become the third option when both the RF flap and the anterolateral thigh pedicle flap are not useful.
STRENGTH & LIMITATIONS
UNASSIGNED
Flap combination phalloplasty is a complex operative procedure with a prolonged operative time, but it can provide more flap selection and reduce the morbidity at each donor site. Choosing from many different options can be beneficial to patients.
CONCLUSION
CONCLUSIONS
Flap combination phalloplasty has a similar complication rate to other procedures and has advantages in terms of flexibility and less donor site morbidity; it may thus be an option when either the RF flap or the anterolateral thigh pedicle flap cannot be used. Namba Y, Watanabe T, Kimata Y. Flap Combination Phalloplasty in Female-to-Male Transsexuals. J Sex Med 2019;16:934-941.
Identifiants
pubmed: 30894300
pii: S1743-6095(19)30412-6
doi: 10.1016/j.jsxm.2019.02.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
934-941Informations de copyright
Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.