title: Pedicled superficial inferior epigastric artery perforator flap for salvage of failed metoidioplasty in female-to-male transsexuals.
abstract: Metoidioplasty represents a viable option for female-to-male transsexual patients seeking gender reassignment surgery. The aim of this procedure is to create a microphallus with lengthening of the urethra to the tip of the hypertrophied and released clitoris. However, fistula formation and urethral obstruction might occur in the long term and reconstruction represents a challenging problem in this setting. In this report, we present the tubed superficial inferior epigastric artery perforator island flap as an option for urethral reconstruction after failed metoidioplasty in a female-to-male transsexual patient. In a 26-year-old transsexual patient a combination of urethral fistula, urethral stenosis, and disintegrated distal neourethra had developed as a consequence of postoperative hematoma formation. Metoidioplasty was reconstructed by means of a tubed, pedicled superficial inferior epigastric artery perforator flap from the left lower abdomen. The long-term result was stable with pleasing genital appearance, adequate functional outcome, and satisfactory donor site morbidity. In our opinion, this procedure may represent a viable alternative for urethral reconstruction in thin patients.
authors.affiliation: Section of Plastic and Reconstructive Surgery, Department of General Surgery, General Hospital Linz, Linz, Austria.|Microsurgical Training and Research Center - maz, Linz, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Section of Plastic and Reconstructive Surgery, Department of General Surgery, General Hospital Linz, Linz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Grohmann
authors.affiliation: Section of Plastic and Reconstructive Surgery, Department of General Surgery, General Hospital Linz, Linz, Austria.|Microsurgical Training and Research Center - maz, Linz, Austria.
authors.forename: Georg M
authors.initials: GM
authors.lastname: Huemer
mesh_terms: D000328:Adult; D019074:Epigastric Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D061525:Perforator Flap; D016879:Salvage Therapy / Q000379:methods*; D057830:Gender-Affirming Surgery / Q000379:methods*; D014189:Transsexualism / Q000601:surgery*