title: Total urethral construction with the radial artery-based forearm free flap in the transsexual.
abstract: OBJECTIVE
  to report our experience of using a radial artery-based forearm free flap urethroplasty (RAFFFU) inside a pre-fashioned pedicled pubic phalloplasty for female-to-male gender reassignment.
  
  
  METHODS
  a neourethra based on the RAFFF was incorporated into a previously constructed phalloplasty in 27 patients. Surgical outcome, patients' satisfaction and voiding sensation of the neourethra were subjectively and prospectively assessed by direct questioning during the follow-up.
  
  
  RESULTS
  after a median follow-up of 9.2 months, all patients who completed the two stages of the procedure were able to void from the tip of the phallus while standing. Donor-site morbidity was minimal, with all patients reporting a complete recovery of forearm sensation and mobility. The overall satisfaction rate was 92%.
  
  
  CONCLUSIONS
  the RAFFFU is the best technique of total urethral construction in female-to-male transsexuals who opt not to undergo a RAFFF phalloplasty.
authors.affiliation: St Peter's Andrology Centre and the Institute of Urology, London, UK.
authors.forename: Giulio
authors.initials: G
authors.lastname: Garaffa
authors.forename: David J
authors.initials: DJ
authors.lastname: Ralph
authors.forename: Nim
authors.initials: N
authors.lastname: Christopher
mesh_terms: D000328:Adult; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation / Q000601:surgery*; D017534:Radial Artery; D057830:Gender-Affirming Surgery / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014189:Transsexualism / Q000601:surgery*; D016896:Treatment Outcome; D014521:Urethra / Q000294:innervation / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods