title: Gender reassignment surgery for male primary transsexuals.
abstract: This article describes certain innovations and aspects of surgical technique together with some surgical assessments of results in a series of 58 operations for gender reassignment undertaken by the author over the past 24 years. The salient new features described are: (i) to prevent the early and late vaginal contractures that commonly follow previously accepted methods of neo-vagina construction, the technique of dissecting a new vaginal canal has been improved, and an improved skin graft (double-layered) is added to the peno-scroto-perineal flaps used to line the vaginal canal--these split-skin grafts, superimposed upon a meshed thick dermal graft, do not contract nearly as much as solitary split-skin grafts; (ii) the vagina is suspended laterally by the testicular cords, threaded above the superior pubic rami; and (iii) repeated intermittent use of a vaginal vibrator is substituted for an indwelling vaginal mould, resulting in better compliance and a more pliable vagina.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Natal, Durban.
authors.forename: D
authors.initials: D
authors.lastname: Crichton
mesh_terms: D005837:Genitalia, Male / Q000601:surgery*; D006801:Humans; D008297:Male; D011182:Postoperative Care; D013518:Surgery, Plastic / Q000379:methods*; D014189:Transsexualism / Q000601:surgery* / Q000628:therapy