[Modern concept for treatment of the female-to-male transsexual].
BACKGROUND
The experience of our multidisciplinary team in surgical treatment of female-to-male trans-sexualism is presented, and our treatment concepts described in detail. In addition, our preferred technique of neourethra formation using a prefabricated free fibula flap is described.


METHODS
From 1996 to 2003, thirty-four patients underwent gender reassignment surgery as a staged procedure. The neourethra was constructed using an anterior vaginal flap and the prefabricated free fibular flap.


RESULTS
There were four complete losses of the prefabricated fibular flap (11.7%). The neourethra stricture rate was 20.5% and the fistula formation rate was 14.7%. In 82.3% of the patients, the ability to micturate while standing was achieved.


CONCLUSIONS
This modern concept reduces the complication rate and improves the quality of patient outcome.
Dabernig
J
J
Abteilung für Hand-, Mikro- und Plastische Chirurgie, Amper-Kliniken AG, Klinikum Dachau, Dachau, Germany.
Schumacher
O
O
Lenz
C
C
Rickard
R
R
Turner
A
A
Dabernig
W
W
Schaff
J
J
D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D010413:Penis / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D013536:Suture Techniques; D014189:Transsexualism / Q000601:surgery*; D014521:Urethra / Q000601:surgery*; D014621:Vagina / Q000601:surgery; D014945:Wound Healing / Q000502:physiology