title: Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery.
abstract: BACKGROUND
  Male-to-female sex reassignment surgery involves three main procedures, namely, clitoroplasty, new urethral meatoplasty and vaginopoiesis. Herein we describe the key steps of our surgical technique.
  
  
  METHODS
  Male-to-female sex reassignment surgery includes the following 14 key steps which are documented in this article: (1) patient installation and draping, (2) urethral catheter placement, (3) scrotal incision and vaginal cavity formation, (4) bilateral orchidectomy, (5) penile skin inversion, (6) dismembering of the urethra from the corpora, (7) neoclitoris formation, (8) neoclitoris refinement, (9) neovaginalphallic cylinder formation, (10) fixation of the neoclitoris, (11) neovaginalphallic cylinder insertion, (12) contouring of the labia majora and positioning the neoclitoris and urethra, (13) tie-over dressing and (14) compression dressing.
  
  
  RESULTS
  The size and position of the neoclitoris, position of the urethra, adequacy of the neovaginal cavity, position and tension on the triangular flap, size of the neo labia minora, size of the labia majora, symmetry and ease of intromission are important factors when considering the immediate results of the surgery. We present our learning process of graduated responsibility for optimisation of these results. We describe our postoperative care and the possible complications.
  
  
  CONCLUSIONS
  Herein, we have described the 14 steps of the Baudet technique for male-to-female sex reassignment surgery which include clitoroplasty, new urethral meatoplasty and vaginopoiesis. The review of each key stage of the procedure represents the first step of our global teaching process.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Centre of Expertise for Sex Reassignment Surgery, Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University Hospital of Bordeaux and University of Bordeaux, Centre François-Xavier-Michelet, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France. franckleclere@yahoo.fr.
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.affiliation: Centre of Expertise for Sex Reassignment Surgery, Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University Hospital of Bordeaux and University of Bordeaux, Centre François-Xavier-Michelet, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Casoli
authors.affiliation: Centre of Expertise for Sex Reassignment Surgery, Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University Hospital of Bordeaux and University of Bordeaux, Centre François-Xavier-Michelet, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Baudet
authors.affiliation: Centre of Expertise for Sex Reassignment Surgery, Department of Plastic & Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University Hospital of Bordeaux and University of Bordeaux, Centre François-Xavier-Michelet, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Weigert
mesh_terms: D002987:Clitoris / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D057830:Gender-Affirming Surgery / Q000193:education* / Q000379:methods*; D014521:Urethra / Q000601:surgery; D014621:Vagina / Q000601:surgery
keywords: Learning curve; Male-to-female transsexual; Sex reassignment surgery; Transsexualism; Vaginoplasty; Vaginopoiesis