title: New technique of total phalloplasty with reinnervated latissimus dorsi myocutaneous free flap in female-to-male transsexuals.
abstract: From December 2001 to September 2005, the technique of total penile reconstruction with a reinnervated free latissimus dorsi myocutaneous flap was used in 22 patients (24-38 years old) with gender dysphoria. These patients were followed up for at least 11 months (range, 11-44 months). All flaps survived. Complications include hematoma (7 cases), vascular thrombosis (2 cases), partial necrosis (1 case), excessive swelling of the neophallus (3 cases), and skin graft loss at the donor site (1 case). Of the 19 patients included in the final evaluation, the transplanted muscle was able to obtain contraction in 18 (95%) cases and 8 patients (42%) had sexual intercourse by contracting the muscle to stiffen and move the neopenis. The described technique of neophalloplasty proved to be a reliable technique and the muscle movement in the neophallus can be expected in almost all cases. The muscle contraction in the neophallus leads to "paradox" erection-stiffening, widening, and shortening of the neopenis, which allows for sexual intercourse in some patients. Subsequent reconstruction of the urethra is possible.
authors: Clinic of Plastic and Aesthetic Surgery, St. Anna University Hospital, Masaryk University in Brno, Brno, Czech Republic. jiri.vesely@fnusa.cz
authors: Jiri
authors: J
authors: Vesely
authors: Petr
authors: P
authors: Hyza
authors: Raul
authors: R
authors: Ranno
authors: Emanuele
authors: E
authors: Cigna
authors: Nicola
authors: N
authors: Monni
authors: Igor
authors: I
authors: Stupka
authors: Ivan
authors: I
authors: Justan
authors: Zdenek
authors: Z
authors: Dvorak
authors: Pavel
authors: P
authors: Novak
authors: Salvatore
authors: S
authors: Ranno
mesh_terms: D003075:Coitus; D005260:Female; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000637:transplantation; D010413:Penis / Q000502:physiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014189:Transsexualism / Q000601:surgery*