title: Long-term evaluation of donor-site morbidity after radial forearm flap phalloplasty for transsexual men.
abstract: BACKGROUND
  Phalloplasty using the radial forearm flap is currently the most frequently used technique to create the neophallus in transsexual men (formerly described as female-to-male transsexual persons). Although it is considered the gold standard, its main disadvantage is the eventual donor-site morbidity in a young, healthy patient population.
  
  
  OBJECTIVE
  The study aims to examine the long-term effects of radial forearm flap phalloplasty in transsexual men and to evaluate aesthetic outcome, scar acceptance, bone health, and daily functioning.
  
  
  METHODS
  Scars were evaluated with the patient and observer scar assessment scale, the Vancouver Scar Scale, and self-reported satisfaction. Bone health was assessed using dual X-ray absorptiometry and peripheral quantitative computed tomography, and daily functioning using a physical activity questionnaire (Baecke). These measurements were compared with 44 age-matched control women.
  
  
  METHODS
  This is a cross-sectional study of 44 transsexual, a median of 7 years after radial forearm flap phalloplasty, recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital, Belgium.
  
  
  RESULTS
  We observed no functional limitations on daily life activities, a pain-free and rather aesthetic scar, and unaffected bone health a median of 7 years after radial foreram flap phalloplasty. Over 75% of transsexual men were either satisfied or neutral with the appearance of the scar.
  
  
  CONCLUSIONS
  Transsexual men, despite scarring the forearm, consider the radial forearm flap phalloplasty as worthwhile.
authors.affiliation: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. eva.vancaenegem@ugent.be
authors.forename: Eva
authors.initials: E
authors.lastname: Van Caenegem
authors.forename: Evelien
authors.initials: E
authors.lastname: Verhaeghe
authors.forename: Youri
authors.initials: Y
authors.lastname: Taes
authors.forename: Katrien
authors.initials: K
authors.lastname: Wierckx
authors.forename: Kaatje
authors.initials: K
authors.lastname: Toye
authors.forename: Stefan
authors.initials: S
authors.lastname: Goemaere
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Zmierczak
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.forename: Stan
authors.initials: S
authors.lastname: Monstrey
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
mesh_terms: D000328:Adult; D001828:Body Image; D001842:Bone and Bones / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002921:Cicatrix / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D005542:Forearm / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010413:Penis / Q000601:surgery*; D011859:Radiography; D057566:Self Report; D057829:Gender-Affirming Procedures / Q000009:adverse effects; D013524:Surgical Flaps / Q000009:adverse effects; D013997:Time Factors; D014189:Transsexualism / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult