PHALLIC CONSTRUCTION IN FEMALE-TO-MALE TRANSSEXUALS USING A LATERAL UPPER ARM SENSATE FREE-FLAP AND A BLADDER MUCOSA GRAFT

We devised a technique for phalloplasty in a female-to-male transsexua l combining the lateral upper arm free flap with a bladder mucosa graf t, to address the ideal requirements of phalloplasty in the best possi ble way. The surgical techniques are described. Healing of the phallus has been uneventful, but postoperative bladder spasms, meatal stenosi s, and an intraurethral valve were encountered. The cosmetic result of the phalloplasty is pleasing. Sensibility is still increasing after a 14-month follow-up. Scarring of the upper arm donor site can be camou flaged easily. Although the actual phalloplasty as described in this a rticle is a one-stage microsurgical procedure that appears to be repro ducible, the construction of a phallus meeting all requirements still implies more than one stage.