PRECONSTRUCTION OF THE PARS-PENDULANS-URETHRAS FOR PHALLOPLASTY IN FEMALE-TO-MALE TRANSSEXUALS

One of the goals of phallic construction in female-to-male transsexual s should be the creation of a competent neourethra that allows patient s to void while standing. Apart from constructing the perineal fixed p art of the neourethra, it is therefore necessary to create a phallus w ith a pendulant part of the neourethra to be connected to the pars fix a urethrae. In patients in whom we apply microsurgical free-flap techn iques for phalloplasty, the pars pendulans is usually created the Chin ese way (n = 8). If, on the other hand, pedicled abdominal or inguinal skin flaps are used, a skin-lined urethral tube to be incorporated in the phallus should already be extant in the donor area of the flap (n = 25). In the 20-year period 1971-1991, such a preconstruction of the pars pendulans urethrae has been attempted in 25 female-to-male trans sexuals employing Snyder's technique. This has been successful in all and uneventful in 17 patients. If malelike micturition while standing is the goal and the use of microsurgical free-flap techniques is not i ndicated, this procedure seems to be the method of choice.