Jj. Hage et al., CONSTRUCTION OF THE NEOPHALLUS IN FEMALE-TO-MALE TRANSSEXUALS - THE AMSTERDAM EXPERIENCE, The Journal of urology, 149(6), 1993, pp. 1463-1468
Until April 1991, 31 phalloplasties were performed in 28 patients at o
ur hospital. Operative techniques and results of the use of the superf
icial inferior epigastric pedicled skin flap, rectus abdominis myocuta
neous pedicled flap and radial forearm free flap for phalloplasty are
presented and discussed. Functionally and cosmetically, the microsurgi
cal free flap phalloplasty techniques lead to the best results. In all
cases of free flap phalloplasty in our series tactile sensitivity rec
urred in the neophallus. However, erogenous sensibility should not be
expected. We regard use of the infraumbilical flap to be a technique w
ith few indications and it should not be applied to obese patients. Us
e of the rectus abdominis myocutaneous pedicled flap is a reliable tec
hnique. Primary connection of the pars fixa and pars pendulans urethra
e often leads to formation of fistulas at the level of the anastomosis
. Genital reassignment surgery in female-to-male transsexuals can seld
om be achieved in 1 stage and this should be made clear to the patient
before any form of surgery is done.