A modified method of urethral anastomosis of phalloplasty in female-to-male transsexuals
10.3760/cma.j.cn114453-20210412-00164
- VernacularTitle:易性病阴茎再造术中尿道口吻合的改良术式介绍
- Author:
Zhiwan LIU
1
;
Feng ZHOU
;
Zheyuan HU
;
Wenjun ZHANG
;
Xiang JIE
;
Xiaohai ZHU
Author Information
1. 海军军医大学第二附属医院整形外科，上海 200003
- Keywords:
Sex reassignment surgery;
Urinary fistula;
Penile reconstruction;
Female-to-male transsexuals;
Urethral stricture
- From:
Chinese Journal of Plastic Surgery
2022;38(1):64-68
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of modified urethral anastomosis in penile reconstruction for female-to-male(FTM) transsexuals.Methods:A retrospective analysis was performed on the FTM transsexuals undergoing penile and urethral reconstruction in Second Affiliated Hospital of Naval Medical University from December 2016 to December 2020. In this method, lower abdominal flap and anterolateral thigh (ALT) flap were used to reconstruct the neophallus, and vaginal mucosa was used to reconstruct the urethra step by step. The 2 stage procedure was divided into 3 stage. During the second stage operation, a 2 cm wide flap bridge was reserved near the perineal end of the prefabricated urethral opening, which separated the prefabricated urethral from the urethra reserved at the pubic area. And the third stage urethral anastomosis was performed 6 months later. The urethral function after penile reconstruction was followed up to observe whether the patients had urinary fistula, standing urination and urethral patency.Results:A total of 6 FTM transsexuals, aged 29-40 years, were enrolled in the study. The operation was successful. Among them, the right ALT flap was used in 4 cases, and the left lower abdominal flap was used in 2 cases. In one case, partial flap necrosis was found in the distal part of the penis one week after the second stage surgery, which healed with free skin grafting after 2 weeks. During postoperative follow-up of 10-30 months, no urinary fistula occurred and all patients were able to urinate standing up, with no urethral stricture.Conclusions:The urethra was prefabricated with a lower abdominal flap or ALT flap, and then the procedure of phalloplasty and modified urethral anastomosis was performed in stages, which could reduce the incidence of urinary fistula and urethral stricture in FTM transsexuals.
